Youssef Arkoubi Amr
Department on Anesthesia and Surgery, Faculty of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 11564, Saudi Arabia.
J Clin Med. 2025 Apr 10;14(8):2593. doi: 10.3390/jcm14082593.
: Velopharyngeal insufficiency (VPI) is a failure of the sphincter mechanism, causing speech patterns like hypernasality and decreased intelligibility. Causes include structural, neurologic, and mechanical issues. Treatment options include non-surgical and surgical interventions, but complications can arise. A new approach using the buccal flap (BF) has been suggested for palatal length augmentation. This systematic review assessed speech outcomes after BF palatal lengthening. : A thorough investigation was conducted by methodically reviewing numerous databases, including PubMed, Scopus, Web of Science, and Embase, until December 2024. The goal of our analysis was to find studies that assess the short- and long-term efficacy of BF on speech outcomes on patients with VPI. We used the NIH Quality Assessment Tool to assess the quality of the evidence, ensuring the dependability of the results reached during these investigations. : This systematic review identified 23 studies (total sample size of 995) that assessed the speech outcomes of BF on VPI. The BF significantly improves speech outcomes in patients with VPI. Hypernasality improved significantly post-surgery, with outcomes measured using different scales and methods, including both subjective and objective tools. Benefits were observed within three months postoperatively, with sustained benefits up to 15 months in several studies. Speech intelligibility also improved notably, with mean differences up to 1.09 ( < 0.001). Reductions in audible nasal air emissions were observed, though some variability was noted across studies. Secondary outcomes, including better velopharyngeal closure and decreased facial grimacing, further highlight its efficacy. However, inconsistent findings for nasal turbulence and limited long-term data suggest that benefits may plateau over time. These findings support the BF as an effective intervention, though further research is needed on extended outcomes. : BF is an effective surgical intervention for VPI, significantly improving hypernasality, speech intelligibility, and audible nasal air emissions. While benefits are evident across diverse populations, long-term outcomes and secondary features, such as nasal turbulence, show variability, emphasizing the need for individualized approaches and continued follow-up. This technique offers a reliable option for functional and speech rehabilitation, though further research is needed to optimize its long-term efficacy and broader outcomes.
腭咽闭合不全（VPI）是一种括约肌机制功能障碍，会导致诸如鼻音过重和清晰度下降等言语模式。病因包括结构、神经和机械方面的问题。治疗选择包括非手术和手术干预，但可能会出现并发症。有人提出一种使用颊瓣（BF）的新方法来增加腭长度。本系统评价评估了BF腭延长术后的言语结果。：通过系统检索包括PubMed、Scopus、Web of Science和Embase在内的众多数据库，直至2024年12月进行了全面调查。我们分析的目的是找到评估BF对VPI患者言语结果的短期和长期疗效的研究。我们使用美国国立卫生研究院质量评估工具来评估证据质量，确保这些调查得出的结果的可靠性。：本系统评价确定了23项评估BF对VPI言语结果的研究（总样本量为995）。BF显著改善了VPI患者的言语结果。术后鼻音过重显著改善，使用不同量表和方法测量结果，包括主观和客观工具。在术后三个月内观察到益处，在多项研究中可持续长达15个月。言语清晰度也显著提高，平均差异高达1.09（<0.001）。观察到可闻鼻气流量减少，尽管各研究存在一些差异。次要结果，包括更好的腭咽闭合和面部表情减少，进一步突出了其疗效。然而，关于鼻气流紊乱的结果不一致以及长期数据有限表明，益处可能会随着时间推移而趋于平稳。这些发现支持BF作为一种有效的干预措施，尽管需要对长期结果进行进一步研究。：BF是一种治疗VPI的有效手术干预措施，可显著改善鼻音过重、言语清晰度和可闻鼻气流量。虽然在不同人群中益处明显，但长期结果和次要特征，如鼻气流紊乱，存在差异，强调需要个性化方法和持续随访。该技术为功能和言语康复提供了一种可靠选择，尽管需要进一步研究以优化其长期疗效和更广泛的结果。
