Surgical management of XXXX in @entity2418 .

@entity1 @entity2422 @entity1739 @entity53720 @entity2419 @entity2418
OBJECTIVES: To analyze the results of surgery for @entity1739 ( @entity1739 ) in @entity2418 . DESIGN: Prospective data collection, with randomized, blind assessment of speech and velopharyngeal function on lateral videofluoroscopy and nasendoscopy. SETTING: Two-site, tertiary referral cleft unit. @entity1 : Forty-two consecutive @entity1 with the 22q11 deletion underwent surgery for symptomatic @entity1739 by a single surgeon. INTERVENTIONS: Intraoral examinations, lateral videofluoroscopy (+/- nasendoscopy) and intraoperative evaluation of the position of the velar muscles through the operating microscope. Based on these findings, either a radical dissection and retropositioning of the velar muscles ( @entity2419 [ @entity53720 repair]) or a Hynes pharyngoplasty (posterior pharyngeal wall augmentation pharyngoplasty) was performed. As anticipated, a proportion of @entity1 undergoing @entity53720 repair subsequently required a Hynes. The aim of this staged approach was to maximize velar function, thereby enabling a less obstructive pharyngoplasty to be performed. Thus, there were three surgical groups for analysis: @entity53720 alone, Hynes alone, and @entity53720 +Hynes. MAIN OUTCOME MEASURES: Blind perceptual rating of resonance and nasal airflow; blind assessment of velopharyngeal function on lateral videofluoroscopy and nasendoscopy; and identification of predictive factors. RESULTS: Significant improvement in @entity2422 in all three groups. The @entity53720 +Hynes group also showed significant improvement in nasal emission. There were significant improvements in the extended and resting velar lengths following @entity53720 repair and a trend toward increased velocity of closure. CONCLUSIONS: Depending on velopharyngeal anatomy and function, there is a role for @entity53720 repair, Hynes pharyngoplasty, and a staged combination of @entity53720 +Hynes, all of which are procedures with a low morbidity.
