Surgical treatment of borderline velopharyngeal insufficiency using homologous cartilage implantation with videonasopharyngoscopic monitoring.

Borderline cases of velopharyngeal insufficiency were treated with homologous cartilage implants. The selection of patients and technique for this procedure are described. Videonasopharyngoscopy was used to identify a specific location on the posterior pharyngeal wall for the implant. A small cube of homologous cartilage was implanted in the selected site in order to achieve adequate closure. The preliminary nasopharyngoscopic and speech evaluation results in 10 patients, who were followed every 3 months for at least 1 year, are reported. Hypernasality and audible nasal emission were eliminated. The displacement and reabsorption of the implants that occurred was minimal and did not affect velopharyngeal closure. Homologous cartilage, which is inexpensive and easy to obtain, appears to be a good option for implantation in the posterior pharyngeal wall in borderline cases of velopharyngeal insufficiency.