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Autologous fat transplantation to the velopharynx for treating persistent velopharyngeal insufficiency of mild degree secondary to overt or submucous cleft palate.
J Plast Reconstr Aesthet Surg 2013; 66(3):337-44JP

Abstract

BACKGROUND

Autologous fat transplantation to the velopharynx has been described in a few smaller studies including heterogeneous groups of patients for the treatment of velopharyngeal insufficiency (VPI). The aim of this study was to evaluate speech and to measure velopharyngeal closure with magnetic resonance imaging (MRI) in patients who underwent autologous fat transplantation for the treatment of persistent VPI of mild degree secondary to overt or submucous cleft palate.

METHODS

A prospective study of 16 patients with persistent VPI of mild degree secondary to overt or submucous cleft palate who underwent autologous fat transplantation to the velopharynx. The patients were injected with a median of 5.6 (3.8-7.6) ml autologous fat to the velopharynx. Pre- and 1-year postoperative audio recordings were blinded for scoring independently by three senior speech therapists. Hypernasality, hyponasality, nasal turbulence and audible nasal emission were scored on a five-point scale. Pre- and 1-year postoperative MRIs were obtained during vocal rest and during phonation in 12 patients. Data measured were the velopharyngeal distance in the sagittal plane and the velopharyngeal gap area in the axial plane.

RESULTS

Hypernasality improved significantly (p=0.030), but not audible nasal emission (p=0.072) or nasal turbulence (p=0.12). The velopharyngeal distance during phonation decreased significantly (p=0.013), but not the velopharyngeal gap area (p=0.16). There was no significant correlation between speech and MRI results.

CONCLUSION

Autologous fat transplantation to the velopharynx improved hypernasality significantly, but not audible nasal emission or nasal turbulence in patients with persistent VPI of mild degree secondary to overt or submucous cleft palate. Given the low number of patients and the lack of a control group, the value of fat transplantation for the treatment of mild VPI is not proven for sure.

Authors+Show Affiliations

Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, PO Box 4950, Nydalen, 0424 Oslo, Norway. cfilip@ous-hf.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23254179

Citation

Filip, Charles, et al. "Autologous Fat Transplantation to the Velopharynx for Treating Persistent Velopharyngeal Insufficiency of Mild Degree Secondary to Overt or Submucous Cleft Palate." Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS, vol. 66, no. 3, 2013, pp. 337-44.
Filip C, Matzen M, Aagenæs I, et al. Autologous fat transplantation to the velopharynx for treating persistent velopharyngeal insufficiency of mild degree secondary to overt or submucous cleft palate. J Plast Reconstr Aesthet Surg. 2013;66(3):337-44.
Filip, C., Matzen, M., Aagenæs, I., Aukner, R., Kjøll, L., Høgevold, H. E., & Tønseth, K. (2013). Autologous fat transplantation to the velopharynx for treating persistent velopharyngeal insufficiency of mild degree secondary to overt or submucous cleft palate. Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS, 66(3), pp. 337-44. doi:10.1016/j.bjps.2012.11.006.
Filip C, et al. Autologous Fat Transplantation to the Velopharynx for Treating Persistent Velopharyngeal Insufficiency of Mild Degree Secondary to Overt or Submucous Cleft Palate. J Plast Reconstr Aesthet Surg. 2013;66(3):337-44. PubMed PMID: 23254179.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Autologous fat transplantation to the velopharynx for treating persistent velopharyngeal insufficiency of mild degree secondary to overt or submucous cleft palate. AU - Filip,Charles, AU - Matzen,Michael, AU - Aagenæs,Ingegerd, AU - Aukner,Ragnhild, AU - Kjøll,Lillian, AU - Høgevold,Hans Erik, AU - Tønseth,Kim, Y1 - 2012/12/17/ PY - 2012/03/12/received PY - 2012/08/25/revised PY - 2012/11/13/accepted PY - 2012/12/21/entrez PY - 2012/12/21/pubmed PY - 2013/4/24/medline SP - 337 EP - 44 JF - Journal of plastic, reconstructive & aesthetic surgery : JPRAS JO - J Plast Reconstr Aesthet Surg VL - 66 IS - 3 N2 - BACKGROUND: Autologous fat transplantation to the velopharynx has been described in a few smaller studies including heterogeneous groups of patients for the treatment of velopharyngeal insufficiency (VPI). The aim of this study was to evaluate speech and to measure velopharyngeal closure with magnetic resonance imaging (MRI) in patients who underwent autologous fat transplantation for the treatment of persistent VPI of mild degree secondary to overt or submucous cleft palate. METHODS: A prospective study of 16 patients with persistent VPI of mild degree secondary to overt or submucous cleft palate who underwent autologous fat transplantation to the velopharynx. The patients were injected with a median of 5.6 (3.8-7.6) ml autologous fat to the velopharynx. Pre- and 1-year postoperative audio recordings were blinded for scoring independently by three senior speech therapists. Hypernasality, hyponasality, nasal turbulence and audible nasal emission were scored on a five-point scale. Pre- and 1-year postoperative MRIs were obtained during vocal rest and during phonation in 12 patients. Data measured were the velopharyngeal distance in the sagittal plane and the velopharyngeal gap area in the axial plane. RESULTS: Hypernasality improved significantly (p=0.030), but not audible nasal emission (p=0.072) or nasal turbulence (p=0.12). The velopharyngeal distance during phonation decreased significantly (p=0.013), but not the velopharyngeal gap area (p=0.16). There was no significant correlation between speech and MRI results. CONCLUSION: Autologous fat transplantation to the velopharynx improved hypernasality significantly, but not audible nasal emission or nasal turbulence in patients with persistent VPI of mild degree secondary to overt or submucous cleft palate. Given the low number of patients and the lack of a control group, the value of fat transplantation for the treatment of mild VPI is not proven for sure. SN - 1878-0539 UR - https://www.unboundmedicine.com/medline/citation/23254179/Autologous_fat_transplantation_to_the_velopharynx_for_treating_persistent_velopharyngeal_insufficiency_of_mild_degree_secondary_to_overt_or_submucous_cleft_palate_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1748-6815(12)00637-7 DB - PRIME DP - Unbound Medicine ER -