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Background <p>Sphincter pharyngoplasty (SP) is a well-established surgical procedure utilized to correct velopharyngeal insufficiency (VPI).</p> Purpose <p>This study aimed to evaluate the long-term anatomical and phoniatric outcomes of palatopharyngeal myo-mucosal flaps following SP.</p> Methods <p>We conducted a retrospective cohort study of 31 non-syndromic, Arabic-speaking patients who underwent SP between May 2014 and January 2020. Participants were followed for a minimum of 48 months. Evaluation included auditory perceptual assessment (APA), video naso-endoscopy of the velopharyngeal sphincter, and nasometric evaluation.</p> Results <p>The cohort included 13 males (41.9%) and 18 females (58.1%) with an age range of 10–18 years at the time of review. While nasal tone and air emission showed transient improvement at 6–8 weeks postoperatively, these gains were not sustained. By 24 months, flaps were undetectable at their original sites in 23 patients (74.19%), with the remaining 8 patients (25.81%) exhibiting only thin ridges on the posterior pharyngeal walls. At the 48-month follow-up, statistical analysis revealed no significant differences (<i>P</i> &gt; 0.05) compared to preoperative data across all parameters, including velopharyngeal closure, speech intelligibility, hypernasality, and nasometric results.</p> Conclusion <p>Anatomically, superiorly based palatopharyngeal myo-mucosal flap is thought to undergo denervation and subsequent atrophy following SP, rendering them non-functional in the long term. These findings suggest that the surgical and functional principles of the procedure warrant reconsideration and further studies.</p>

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Sphincter Pharyngoplasty: An Anatomical-Based Revision of the Technique

  • 期刊论文

  • 发表日期：

    2026年7月13日

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  • Sherif Mohammad Askar,
  • Nasser labib Alnakib,
  • Mohammad Al-Shawadfy,
  • Ashraf Elhussiny,
  • Alsayed Abdulmageed,
  • Mohamed O. Atta

摘要

Background

Sphincter pharyngoplasty (SP) is a well-established surgical procedure utilized to correct velopharyngeal insufficiency (VPI).

Purpose

This study aimed to evaluate the long-term anatomical and phoniatric outcomes of palatopharyngeal myo-mucosal flaps following SP.

Methods

We conducted a retrospective cohort study of 31 non-syndromic, Arabic-speaking patients who underwent SP between May 2014 and January 2020. Participants were followed for a minimum of 48 months. Evaluation included auditory perceptual assessment (APA), video naso-endoscopy of the velopharyngeal sphincter, and nasometric evaluation.

Results

The cohort included 13 males (41.9%) and 18 females (58.1%) with an age range of 10–18 years at the time of review. While nasal tone and air emission showed transient improvement at 6–8 weeks postoperatively, these gains were not sustained. By 24 months, flaps were undetectable at their original sites in 23 patients (74.19%), with the remaining 8 patients (25.81%) exhibiting only thin ridges on the posterior pharyngeal walls. At the 48-month follow-up, statistical analysis revealed no significant differences (P > 0.05) compared to preoperative data across all parameters, including velopharyngeal closure, speech intelligibility, hypernasality, and nasometric results.

Conclusion

Anatomically, superiorly based palatopharyngeal myo-mucosal flap is thought to undergo denervation and subsequent atrophy following SP, rendering them non-functional in the long term. These findings suggest that the surgical and functional principles of the procedure warrant reconsideration and further studies.