Antonio Ysunza1. 1. Clínica de Paladar Hendido, Dirección de Investigación, Hospital General Dr. Manuel Gea González, México DF, México. amvsunza@terra.com.mx
Abstract
INTRODUCTION: Speech velopharyngeal sphincter restoration is generally performed by pharyngeal flap or sphincter pharyngoplasty. OBJECTIVE: Evaluate pharyngeal muscle physiology after pharyngeal flap or sphincter pharyngoplasty using simultaneous electromyography and videonasopharyngoscopy. MATERIAL AND METHODS: Forty patients were studied. Twenty patients were operated on with an upper base pharyngeal flap. Twenty patients were operated on with sphincter pharyngoplasty. The following muscles were studied: superior constrictor pharyngeus, palatopharyngeus, and levator veli palatini. RESULTS: None of the patients studied showed electromyographic activity in the lateral flaps of tile pharyngoplasties. None showed electromyographic activity of the upper base pharyngeal flaps. All patients demonstrated strong electromyographic activity on the superior constrictor pharyngeus and the levator veli palatini. CONCLUSIONS: Lateral pharyngeal flaps in cases of sphincter pharyngoplasties and the central pharyngeal flap in cases of pharyngeal flaps, do not create new sphincters for velopharyngeal closure. The participation of these structures is passive, increasing tissue volume in specific areas, whereas their movements are caused by the contraction of the superior constrictor pharyngeus and the levator veli palatini.
INTRODUCTION: Speech velopharyngeal sphincter restoration is generally performed by pharyngeal flap or sphincter pharyngoplasty. OBJECTIVE: Evaluate pharyngeal muscle physiology after pharyngeal flap or sphincter pharyngoplasty using simultaneous electromyography and videonasopharyngoscopy. MATERIAL AND METHODS: Forty patients were studied. Twenty patients were operated on with an upper base pharyngeal flap. Twenty patients were operated on with sphincter pharyngoplasty. The following muscles were studied: superior constrictor pharyngeus, palatopharyngeus, and levator veli palatini. RESULTS: None of the patients studied showed electromyographic activity in the lateral flaps of tile pharyngoplasties. None showed electromyographic activity of the upper base pharyngeal flaps. All patients demonstrated strong electromyographic activity on the superior constrictor pharyngeus and the levator veli palatini. CONCLUSIONS: Lateral pharyngeal flaps in cases of sphincter pharyngoplasties and the central pharyngeal flap in cases of pharyngeal flaps, do not create new sphincters for velopharyngeal closure. The participation of these structures is passive, increasing tissue volume in specific areas, whereas their movements are caused by the contraction of the superior constrictor pharyngeus and the levator veli palatini.