Maxillofac Plast Reconstr Surg.  2018 ;40(1):23. 10.1186/s40902-018-0164-2.

Investigation of postoperative hypernasality after superiorly based posterior pharyngeal flap

  • 1Research Institute of Speech Sciences, Chonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, 54896 South Korea.
  • 2Department of Oral and Maxillofacial Surgery, Institute of Oral Bioscience, School of Dentistry, Clinical Research Institute of Chonbuk National University Hospital, Chonbuk National University, 20 Gungiro Road, Duckjin-Gu, Jeonju, Chonbuk 54907 South Korea.


Velopharyngeal insufficiency that accompanies speech resonance and articulation disorders can be managed through several intervention methods such as speech-language therapy, prosthetic aids, and surgery. However, for patients with severe hypernasality, surgical interventions are highly recommended. Among available surgical techniques, the posterior pharyngeal flap is most common. CASE PRESENTATION: Two adult males with high nasalance scores underwent superiorly based posterior pharyngeal flap surgery, followed by speech testing by an expert speech-language therapist. Nasalance scores and articulation accuracy were assessed up until 1 year after the surgery. Nasalance scores were measured five times using a nasometer, after which the average value was calculated.
Consistent declines in hypernasality over time are not easy to explain since the pedicled pharyngeal flap narrowed over time, secondary to cicatrization. However, scar tethering of the soft palate in a posterior direction could reduce the velopharyngeal port size over time. Therefore, long-term follow-up with intensive speech therapy is suggested for patients with severe hypernasality.


Nasalance; Nasometer; Cleft palate; Posterior pharyngeal flap; Pharyngoplasty
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