This work was supported by a grant from the National Science Council, Taiwan (NSC 96-2314-B-182A-056). The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Evaluation of velopharyngeal function after relocation pharyngoplasty for obstructive sleep apnea†
Article first published online: 12 FEB 2010
Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 120, Issue 5, pages 1069–1073, May 2010
How to Cite
Li, H.-Y., Lee, L.-A., Fang, T.-J., Lin, W.-N. and Lin, W.-Y. (2010), Evaluation of velopharyngeal function after relocation pharyngoplasty for obstructive sleep apnea. The Laryngoscope, 120: 1069–1073. doi: 10.1002/lary.20850
- Issue published online: 21 APR 2010
- Article first published online: 12 FEB 2010
- Manuscript Accepted: 22 DEC 2009
- Manuscript Revised: 21 DEC 2009
- Manuscript Received: 23 NOV 2009
- National Science Council, Taiwan. Grant Number: NSC 96-2314-B-182A-056
- Obstructive sleep apnea;
- relocation pharyngoplasty;
- velopharyngeal function;
- Level of Evidence: 2c.
To assess if relocation pharyngoplasty (RP) causes velopharyngeal dysfunction in patients with obstructive sleep apnea (OSA) by evaluating perioperative nasalance, nasality, voice, and articulation.
Prospective, comparative study.
Twenty-four OSA patients selected for RP (two women and 22 men; mean age, 35 years) were enrolled for the study of velopharyngeal function in speech. The RP procedure involved removal of supratonsillar adipose tissue, preservation of all palatal muscular structure, splinting the lateral pharyngeal wall, and anterior advancing of the soft palate. Measurements of nasalance (vowel /a/, /i/, consonant /m/, oronasal, oral, and nasal texts), nasality (mirror-fogging test, degree of nasality, Gutzmann test and Bzoch hypernasality test), voice (acoustic analysis), and articulation (velar sound) were taken before RP and 3 months after the procedure and compared.
Comparative analysis of clinical measures showed that no significant differences were found following RP in nasalance (except for the vowel /a/), nasality, articulation, and voice. The only difference with regard to vowel /a/ showed, instead of an increase, a significant decrease of nasalance from 17.3 ± 10.8 to 11.3 ± 6.7 (P = .004), which may be attributed to the advancing and lifting of the soft palate in RP, leading to relaxation of the levator veli palatine and uvular muscles, which facilitates their contraction in velopharyngeal closure during particular vowel phonation.
RP for OSA does not cause velopharyngeal insufficiency in terms of voice, nasality, and articulation in spite of anterior advancement of the soft palate, but does induce a nondetrimental change in nasalance. Laryngoscope, 2010