Up to 30% of patients undergoing primary palatoplasty require secondary surgery due to velopharyngeal insufficiency (VPI). 1 In patients with a large pharyngeal gap seen on nasoendoscopy, surgical intervention may risk the development of obstructive sleep apnea. While there are many surgical techniques designed to address VPI, there are limited surgical options available for patients with VPI and a large pharyngeal gap which do not require the obstruction of the pharyngeal airspace with tissue flaps or implants. In this paper, we describe a novel Arrow Revision Palatoplasty (ARP), a technique that combines revision palatoplasty and buccal flaps to concurrently reconstruct the levator sling and lengthen the palate without the creation of obstructive flaps within the pharynx. This paper studies changes in video speech nasopharyngeal endoscopy and perceptual speech analysis in 13 patients undergoing ARP. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV
Hemal et al. (Thu,) studied this question.