Napoli, Joseph A. Vallino, Linda D. BBFRP as a Technique to Manage VPI (Napoli & Vallino, 2019) <div><b>Purpose:</b> The 2 most commonly used operations to treat</div><div>velopharyngeal inadequacy (VPI) are superiorly based</div><div>pharyngeal flap and sphincter pharyngoplasty, both of</div><div>which may result in hyponasal speech and airway</div><div>obstruction. The purpose of this article is to (a) describe</div><div>the bilateral buccal flap revision palatoplasty (BBFRP) as</div><div>an alternative technique to manage VPI while minimizing</div><div>these risks and (b) conduct a systematic review of the</div><div>evidence of BBFRP on speech and other clinical</div><div>outcomes. A report comparing the speech of a child with</div><div>hypernasality before and after BBFRP is presented.</div><div><b>Method:</b> A review of databases was conducted for<br></div><div>studies of buccal flaps to treat VPI. Using the principles of</div><div>a systematic review, the articles were read, and data were</div><div>abstracted for study characteristics that were developed</div><div>a priori. With respect to the case report, speech and</div><div>instrumental data from a child with repaired cleft lip and</div><div>palate and hypernasal speech were collected and analyzed</div><div>before and after surgery.</div><div><b>Results:</b> Eight articles were included in the analysis. The<br></div><div>results were positive, and the evidence is in favor of BBFRP</div><div>in improving velopharyngeal function, while minimizing the</div><div>risk of hyponasal speech and obstructive sleep apnea.</div><div>Before surgery, the child’s speech was characterized by</div><div>moderate hypernasality, and after surgery, it was judged to</div><div>be within normal limits.</div><div><b>Conclusion:</b> Based on clinical experience and results<br></div><div>from the systematic review, there is sufficient evidence</div><div>that the buccal flap is effective in improving resonance</div><div>and minimizing obstructive sleep apnea. We recommend</div><div>it as a first-line approach in selected patients to manage</div><div>VPI.</div><div><br></div><div><div><b>Supplemental Material S1. </b></div><div><b><br></b></div><div><b>Supplemental Material S2.</b><b><br></b></div><div><br></div><div>Napoli, J. A., & Vallino, L. D. (2019). Treating velopharyngeal inadequacy using bilateral buccal flap<br>revision palatoplasty. <i>Perspectives of the ASHA Special Interest Groups.</i> Advance online publication. https://doi.org/10.1044/2019_PERS-SIG5-2019-0005</div></div> velopharyngeal inadequacy;velopharyngeal;pharyngeal flap;sphincter pharyngoplasty;hyponasal speech;airway obstruction;bilateral buccal flap revision palatoplasty;systematic review;hypernasality;databases;studies;study characteristics;case report;speech;instrumental data;children;cleft lip;analysis;obstructive sleep apnea;surgery;normal limits;clinical experience;patients;Linguistic Processes (incl. Speech Production and Comprehension) 2019-10-23
    https://asha.figshare.com/articles/media/BBFRP_as_a_Technique_to_Manage_VPI_Napoli_Vallino_2019_/9919352
10.23641/asha.9919352.v1