Augmentation of the posterior pharyngeal wall with autologous tragal cartilage for velopharyngeal valve insufficiency after repair of cleft palate in pediatric patients

Abstract

Purpose: The aim of this study was to evaluate posterior pharyngeal wall augmentation using autologous tragal cartilage graft in patients with velopharyngeal valve insufficiency (VPI) after simple palatoplasty for cleft palate. Patients and methods: This study included 18 patients with postpalatoplasty VPI (grade 2 or 3), with ages ranging from 5 to 14 years. Patients were followed up for 24–48 months postoperatively. Percent of speech intelligibility and grade of closure of velopharyngeal valve with nasopharyngoscope were evaluated preoperatively and postoperatively. Results: Statistically significant improvement in grade of closure of velopharyngeal valve (P=0.001) and percent of intelligibility (P=0.001) was found after surgery. Conclusion: Augmentation of the posterior pharyngeal wall using tragal cartilage is a safe technique, with generally good surgical and phoniatric outcomes in the management of pediatric patients with grades 2 and 3 VPI after simple palatoplasty to overcome hypernasality.