The pharyngeal flap operation.

Patients with velopharyngeal inadequacy require structural modification of the velopharyngeal area by a prosthesis or by surgery in order to provide a mechanism for intelligible speech. The superiorly based, high-attached, lined pharyngeal flap was chosen for the treatment of velopharyngeal incompetency and the operative technique was described. Results showed that 90 per cent of the patients demonstrated significantly improved or normal velopharyngeal adequacy for speech following surgery, and 92 per cent of the patients demonstrated adequate closure of the velopharyngeal orifice as determined by aerodynamic studies.