A RETROSPECTIVE ANALYSIS OF REVISION SPHINCTER PHARYNGOPLASTY

This retrospective study was undertaken to determine the revision rate for dynamic sphincter pharyngoplasty (DSP) at the University of Michi gan Medical Center to analyze the determinants contributing to the nee d for revision pharyngoplasties, and ultimately to improve primary pha ryngoplasty to avoid the need for revision. The records of 30 children with repaired palatal clefts who presented with velopharyngeal insuff iciency and hypernasal speech, and who underwent DSP from January 1988 through July 1994 were reviewed, Clinical follow-up ranged from 6 to 48 months (mean, 20.2 months), Seven of the original 30 patients (23%) had persistent, moderate-to-severe hypernasality that required reoper ation, while 1 patient (3%) demonstrated hyponasality requiring revisi on, Seven of 8 patients who underwent revision pharyngoplasty had acce ptable speech after revision. Dehiscences, low-lying pharyngoplasty fl aps, and end-to-end suturing of the flaps were the main determinants r esulting in the need for revision, In our study, female gender and old er age was associated with a higher success of primary operation.