Sphincter pharyngoplasty for management of velopharyngeal insufficiency

Velopharyngeal closure is essential for normal speech production. Velopharyngeal insufficiency is characterized by nasal air emissions and hypernasal resonance. The most common surgical procedures used to treat velopharyngeal insufficiency include posterior pharyngeal flap, palatoplasty, and sphincter pharyngoplasty. The sphincter pharyngoplasty is used when fiberoptic nasal endoscopy reveals velopharyngeal inadequacy associated with adequate velar movement but poor lateral wall motion. It is suited for both coronal and circular closure patterns. In our experience, it may be considered for all patients with velopharyngeal inadequacy and transverse orientation of the levator veli palatini.1 This article describes the senior author's method for performing a sphincter pharyngoplasty.