Efficacy of Autologous Cartilage Augmentation of Posterior Pharyngeal Wall in Management of Velopharyngeal Insufficiency A Meta-Analysis study

Abstract

Abstract Background Velopharyngeal dysfunction is a disorder of the velopharyngeal sphincter or valve, which functions to separate the nasal and oral cavities during speech, swallowing, vomiting, blowing, and sucking. When the soft palate and pharyngeal walls are unable to form an effective seal, an abnormal connection between the nasal and oral cavities leads to hypernasal speech, increased nasal resonance, nasal regurgitation, nasal emission, and decreased intraoral pressure during speech. The overall result is decreased speech intelligibility and significant functional and social impairment. Objective To assess the efficacy of autologous cartilage augmentation of posterior pharyngeal wall in the treatment of velopharyngeal insufficiency. Patients and Methods An electronic database search (PubMed, SCOPUS, Embase, Web of Science, and the Cochrane database) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted with the goal of identifying all available studies related to use of cartilage graft in posterior pharyngeal wall augmentation in Velopharyngeal insufficiency to 2022. Results Rate of improvement in nasal hyper resonance was 82%. Rate of improvement in speech intelligibility was 85%. Rate of improvement in velopharyngeal closure was 76%. Rate of improvement in nasal emission was 61%. Conclusion We conclude that cartilage augmentation of posterior pharyngeal wall is appropriate for patients with minimal velopharyngeal gap and is effective for improvement of velopharyngeal closure and speech.