Posterior wall augmentation for treatment of velopharyngeal insufficiency

Velopharyngeal insufficiency (VPI) can be treated surgically with various o perations, This article describes the use of a superiorly based folded phar yngeal flap for posterior wall augmentation to treat VPI, This is a retrosp ective study indicating that a folded flap to augment the posterior wall is likely to be as effective as other surgical techniques to treat small velo pharyngeal gaps. Patients selected for this procedure had very good velar m otion. Postoperative nasometric zoo passage scores improved by an average o f 18 over preoperative scores. Additionally, a correlation was found betwee n age and nasometry improvement after surgery. Younger patients did better. Patients in whom VPI was caused by adenoidectomy did well. The 2 syndromic patients did not do as well when treated with this type of operation.