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MeSH Review:

Velopharyngeal Insufficiency

Losken, A. et al., Dyce, O. et al., Lewin, M.L. et al., Harding, A. et al., Bennun, M. et al., et al.

Perkins, Sie, Gray, Sie, Tampakopoulou, Sorom, Gruss, Eblen,

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Disease relevance of Velopharyngeal Insufficiency

The first, a 9-year-old girl, presented with microcephaly, characteristic face, congenital heart disease, and velopharyngeal insufficiency [1].
Diagnoses included velopharyngeal insufficiency alone (n = 63), velopharyngeal insufficiency associated with cleft palate (n = 127), velocardiofacial syndrome (n = 32), submucous cleft (n = 15), and other (n = 13) [2].
OUTCOME MEASURE: All otolaryngologic problems were recorded, including facial dysmorphic features, velopharyngeal insufficiency, speech and airway abnormalities, feeding difficulties, gastroesophageal reflux, hearing loss, otitis media, sinus problems, and vascular anomalies [3].

High impact information on Velopharyngeal Insufficiency

New findings in a patient with Dubowitz syndrome: velopharyngeal insufficiency and hypoparathyroidism [4].
The revision rate was highest in those patients with velocardiofacial syndrome (21.8 percent) and lowest in patients with velopharyngeal insufficiency alone (6.3 percent) [2].
Two hundred fifty patients underwent sphincter pharyngoplasty for velopharyngeal insufficiency between January of 1987 and March of 2001 [2].
PATIENTS: One hundred patients undergoing superior pharyngeal flap surgery for the correction of velopharyngeal insufficiency were randomly divided into 2 equal groups to receive either isoflurane or propofol-based anesthesia [5].
Since 1994, the authors have used the position of the levator veli palatini musculature to determine type of surgical intervention recommended for the management of velopharyngeal insufficiency [6].

Chemical compound and disease context of Velopharyngeal Insufficiency

A relationship between coronal pattern of velopharyngeal closure and velopharyngeal insufficiency was found [7].
Finally, some of the available evidence on speech in relation to structural imperfections, such as unrepaired clefts, velopharyngeal insufficiency, oro-nasal fistulae, dental and occlusal deviations, and open-mouth posture is summarised briefly [8].

Anatomical context of Velopharyngeal Insufficiency

Internal carotid arteries of unusual size and tortuosity were found before or at the time of pharyngeal flap surgery in three children who had the velocardiofacial syndrome with velopharyngeal insufficiency [9].
With the help of nasopharyngoscopy, it was possible to delineate specific morphologic changes in the palates of patients with velopharyngeal insufficiency, without an overt cleft and without the triad of symptoms of submucous cleft palate, visible through the oral cavity [10].

Gene context of Velopharyngeal Insufficiency

Velopharyngeal insufficiency in hemifacial microsomia [11].
Sudden onset of velopharyngeal insufficiency in Klippel-Feil syndrome [12].

Analytical, diagnostic and therapeutic context of Velopharyngeal Insufficiency

Persistent velopharyngeal insufficiency following adenoidectomy (VIA) may occur in association with an unrecognized syndrome, such as velocardiofacial syndrome (VCFS) [13].

References

Juvenile rheumatoid arthritis in velo-cardio-facial syndrome: coincidence or unusual complication? Rasmussen, S.A., Williams, C.A., Ayoub, E.M., Sleasman, J.W., Gray, B.A., Bent-Williams, A., Stalker, H.J., Zori, R.T. Am. J. Med. Genet. (1996) [Pubmed]
An outcome evaluation of sphincter pharyngoplasty for the management of velopharyngeal insufficiency. Losken, A., Williams, J.K., Burstein, F.D., Malick, D., Riski, J.E. Plast. Reconstr. Surg. (2003) [Pubmed]
Otolaryngologic manifestations of the 22q11.2 deletion syndrome. Dyce, O., McDonald-McGinn, D., Kirschner, R.E., Zackai, E., Young, K., Jacobs, I.N. Arch. Otolaryngol. Head Neck Surg. (2002) [Pubmed]
New findings in a patient with Dubowitz syndrome: velopharyngeal insufficiency and hypoparathyroidism. Lerman-Sagie, T., Merlob, P., Shuper, A., Kauli, R., Kozokaro, Z., Grunebaum, M., Mimouni, M. Am. J. Med. Genet. (1990) [Pubmed]
Anesthetic techniques for pharyngeal flap surgery: effects on postoperative complications. Bennun, M., Goldstein, B., Zohar, E., Finkelstein, Y., Jedeikin, R., Fredman, B. Arch. Otolaryngol. Head Neck Surg. (2002) [Pubmed]
Results with Furlow palatoplasty in management of velopharyngeal insufficiency. Sie, K.C., Tampakopoulou, D.A., Sorom, J., Gruss, J.S., Eblen, L.E. Plast. Reconstr. Surg. (2001) [Pubmed]
Diagnosis and treatment of submucous cleft palate: a review of 108 cases. García Velasco, M., Ysunza, A., Hernandez, X., Marquez, C. The Cleft palate journal. (1988) [Pubmed]
Characteristics of cleft palate speech. Harding, A., Grunwell, P. European journal of disorders of communication : the journal of the College of Speech and Language Therapists, London. (1996) [Pubmed]
Abnormal carotid arteries in the velocardiofacial syndrome: a report of three cases. MacKenzie-Stepner, K., Witzel, M.A., Stringer, D.A., Lindsay, W.K., Munro, I.R., Hughes, H. Plast. Reconstr. Surg. (1987) [Pubmed]
Velopharyngeal insufficiency due to hypoplasia of the musculus uvulae and occult submucous cleft palate. Lewin, M.L., Croft, C.B., Shprintzen, R.J. Plast. Reconstr. Surg. (1980) [Pubmed]
Velopharyngeal insufficiency in hemifacial microsomia. Luce, E.A., McGibbon, B., Hoopes, J.E. Plast. Reconstr. Surg. (1977) [Pubmed]
Sudden onset of velopharyngeal insufficiency in Klippel-Feil syndrome. Derkay, C.S., Grundfast, K.M., McCullough, D.C. Ear, nose, & throat journal. (1990) [Pubmed]
Presence of 22q11 deletion in postadenoidectomy velopharyngeal insufficiency. Perkins, J.A., Sie, K., Gray, S. Arch. Otolaryngol. Head Neck Surg. (2000) [Pubmed]

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