Proplast as a pharyngeal wall implant to correct velopharyngeal insufficiency.

Proplast I was used as posterior pharyngeal wall implant to correct velopharyngeal insufficiency (VPI) in 26 patients. Specific criteria were followed in patient selection. Follow-up ranged from 4 months to 124 months. Postoperatively, 18 patients had elimination of VPI and three patients had minimal residual VPI. Four patients lost the implants secondary to infection with residual VPI. One patient had significant residual VPI without the loss of the implant. Based on long-term follow-up, no migration of the implant was seen and there was no detectable effect on subsequent facial growth. Predictably better results were achieved with younger patients in whom smaller implants were used. Conclusions from this study indicate that Proplast I is an acceptable pharyngeal wall implant material to correct VPI when the specific criteria are met and good surgical technique is used.