PHARYNGEAL FLAP REVISIONS - FLAP ELEVATION FROM A SCARRED POSTERIOR PHARYNX

Twenty-one consecutive patients who had earlier superiorly based phary ngeal flap surgery and persistent velo-pharyngeal insufficiency were s een between 1976 and 1991. Patients were divided into two treatment gr oups, depending on the results of videofluoroscopic and nasopharyngosc opic assessment. The first group consisted of 18 patients who had bila teral port insufficiency and required a complete reconstruction of a n ew superiorly based pharyngeal flap that was elevated from a scarred p osterior pharyngeal wall. After an average follow-up of 6.2 years, 15 patients had normal resonance, 2 patients had improvement but continue d hypernasality, and 1 patient was hyponasal. The second group consist ed of 3 patients who had ''patch'' flaps to a unilateral port insuffic iency. Postoperatively, all 3 of those patients had normal resonance. Indications for the decision to ''redo'' or patch flaps are described.