• Clinical examination:
• intraoral examination will determine if an
intravelar veloplasty was performed at the
time of cleft palate repair and if the levator
sling is functioning appropriately.
• Provides information regarding the posterior
and superior movement of the velum as "M:U
as the degree of medial excursion of the
lateral pharyngeal walls during speech.
• NON SURGICAL:
• speech therapy.
• prosthetic management with speech bulb or
palatal lift appliances.
• posterior pharyngeal injections or implants.
• Longitudinal incisions through the mucosa and
muscle down to the fascia on each side of the
posterior pharyngeal wall. Dissection is
continued along the fascia. A superiorly based
flap is transversely incised inferiorly and raised
to a level above the palatal plane, An inferiorly
based flap is incised just below the adenoid
pad. The flap is usually inset with tum-back
flaps on the nasal side of the uvula.
• superiorly based flaps raised from the
posterior tonsilar pillars, including mucosa and
the palatopharyngeus muscle.
• the flaps are transposed to the midline and
inset into a defect created by a transverse
incision at the level of the flap base.
Complications of Pharyngeal Surgery
• airway obstruction,
• sleep apnea.(resolve within 5 months )
• surgical revision of the flap.