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Plastic Surgery International
Volume 2013, Article ID 237308, 6 pages
http://dx.doi.org/10.1155/2013/237308
Clinical Study

The Lateral Port Control Pharyngeal Flap: A Thirty-Year Evolution and Followup

1Hermann Memorial Hospital and Hermann Children’s Hospital, Houston, TX 77030, USA
2Houston Plastic and Craniofacial Surgery, 6400 Fannin Suite 2290, Houston, TX 77030, USA
3Institute for Reconstructive Plastic Surgery, New York University, New York, NY 10016, USA

Received 14 August 2012; Accepted 4 November 2012

Academic Editor: Luis Bermudez

Copyright © 2013 Sean Boutros and Court Cutting. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In 1971, Micheal Hogan introduced the Lateral Port Control Pharyngeal Flap (LPCPF) which obtained good results with elimination of VPI. However, there was a high incidence of hyponasality and OSA. We hypothesized that preoperative assessment with videofluoroscopy and nasal endoscopy would enable modification and customization of the LPCPF and result in improvement in the result in both hyponasality and obstructive apnea while still maintaining results in VPI. Thirty consecutive patients underwent customized LPCPF. All patients had preoperative diagnosis of VPI resulting from cleft palate. Patient underwent either videofluoroscopy or nasal endoscopy prior to the planning of surgery. Based on preoperative velar and pharyngeal movement, patients were assigned to wide, medium, or narrow port designs. Patients with significant lateral motion were given wide ports while patients with minimal movement were given narrow ports. There was a 96.66% success rate in the treatment of VPI with one patient with persistent VPI (3.33%). Six patients had mild hyponasality (20 %). Two patients had initial OSA (6.67%), one of which had OSA which lasted longer than six months (3.33%). The modifications of the original flap description have allowed for success in treatment of VPI along with an acceptably low rate of hyponasality and OSA.