An outcome evaluation of sphincter pharyngoplasty for the management of XXXX .

@entity1 @entity1739 @entity2419 @entity2418
Sphincter pharyngoplasty is frequently used for the management of @entity1 with @entity1739 . The purpose of this study was to evaluate outcome and revision rates of sphincter pharyngoplasty at the authors' institution. Two hundred fifty @entity1 underwent sphincter pharyngoplasty for @entity1739 between January of 1987 and March of 2001. There were 117 female @entity1 and 133 male @entity1 , with a mean age at primary sphincter pharyngoplasty of 7.6 years (range, 1 to 45 years). Diagnoses included @entity1739 alone (n = 63), @entity1739 associated with @entity2419 (n = 127), @entity2418 (n = 32), submucous cleft (n = 15), and other (n = 13). Pharyngoplasty revision was defined as any secondary surgical revision of the sphincter as determined by clinical evaluation and objective speech assessment. The pharyngoplasty revision rate was found to be 12.8 percent (n = 32). A favorable outcome was demonstrated in 30 of these @entity1 (93.8 percent) after pharyngoplasty revision. Two @entity1 , one with a diagnosis of a submucous @entity2419 and the other with a @entity2419 , required a second revision because of persistent @entity1739 . The revision rate was highest in those @entity1 with @entity2418 (21.8 percent) and lowest in @entity1 with @entity1739 alone (6.3 percent). @entity1 who required revision had significantly higher preoperative oral sentence nasometry (55.2 percent versus 46.1 percent; p < 0.01) and larger velopharyngeal areas (23.7 mm2 versus 18.9 mm2). There was no significant difference in age or sex for those @entity1 who required a revision compared with those who did not require revision. Mean follow-up was 2.4 years (range, 4 months to 13.6 years). Sphincter pharyngoplasty is an effective procedure for the treatment of @entity1739 using revision rate as the standard of success. It had an 87 percent primary success rate that increased to 99 percent after a single revision. @entity1 with @entity2418 , more severe preoperative hypernasal resonance, and larger velopharyngeal areas were more likely to require pharyngoplasty revision.
