Pharyngeal flap for velopharyngeal incompetence in patients with myotonic dystrophy

Velopharyngeal incompetence (VPI) has been associated with neuromuscular di sorders. Only 4 patients with myotonic dystrophy (MD) who underwent pharyng eal flap elevation for VPI have been reported in the literature. in 3 patie nts, surgery preceded the diagnosis of MD, Cardiorespiratory complications characterized the postoperative period of 3 patients. The authors present 3 patients with VPI and an established diagnosis of MD (by molecular genetic s) who underwent pharyngeal flap elevation. The operation resulted in a maj or improvement in speech in all patients, although some relapse was noted l ater in 1 patient. Contrary to previous reports, none had peri- or postoper ative cardiorespiratory complications. MD, although an uncommon etiology, s hould be considered in cases of late-onset VPI, Owing to differences betwee n the authors' findings and previous reports, additional studies are needed before final conclusions can be reached regarding the benefit and safety o f pharyngeal flap surgery in MD patients. At present, MD should not be cons idered a contraindication for this procedure, although close perioperative monitoring is indicated.