A new video has been posted of an exam showing a patient with a pharyngeal flap that failed to correct his hypernasal speech. Historically, the patient had a cleft lip and palate that was repaired and because of a persistent velopharyngeal insufficiency producing hypernasal speech, a pharyngeal flap was performed. However, this flap was not successful as the hypernasal speech persisted.
The reason for the persistent hypernasal speech in spite of the pharyngeal flap was made apparent on flexible nasopharyngoscopy. The pharyngeal flap was slightly off center AND too small! Compare this with a perfect outcome pharyngeal flap shown here.
Click here to read more and watch the video!
What is a parent of a child with hypernasal speech to do? Well, the first thing is to obtain a video/audio recording of a flexible nasopharyngoscopy (also known as video nasal endoscopy or VNE) just like what was performed here. This exam documents IF there is velopharyngeal insufficiency, WHERE it is located, and HOW BIG the defect is. Than you need to find a plastic surgeon with tremendous experience who can than perform the right surgery that will precisely resolve the defect... and hopefully not create a flap that is too small as in this case. Too big is not good as that would lead to nasal obstruction.
In our practice, we work closely with the INOVA Fairfax Craniofacial Team which has on staff very experienced plastic surgeons headed by Dr. Craig Dufresne.