Modified Z-Palatoplasty for Correction of Acquired Nasopharyngeal Stenosis Following Palatal Surgery: A Case Series

Cleft Palate Craniofac J. 2022 Jun;59(6):774-778. doi: 10.1177/10556656211021702. Epub 2021 Jun 22.

Abstract

Objectives: To evaluate the efficacy of a novel surgical technique in management of nasopharyngeal stenosis (NPS), describing its steps and results. Study Design: Prospective clinical trial.

Setting: This study was conducted at the Otolaryngology, Head and Neck Surgery Department, Zagazig University.

Methods: This prospective study was conducted on patients with snoring ± obstructive sleep apnea due to acquired postsurgical NPS of grade Ι and ΙΙ. New surgical repair was employed on the patients and the pre and postoperative results were statistically compared.

Results: The grade of NPS improved significantly postoperatively (P = .00136) throughout a follow-up of 1 year. Postoperatively, there was statistically significant improvement of apnea hypopnea index (P = .0005), Visual Analog Scale (VAS) of nasal obstruction (P < .0001) and VAS of snoring (P < .0001). Dysphagia showed early worsening, but it improved completely at 3 months postoperatively.

Conclusion: The utilized novel procedure appears effective, low cost, and easily applicable, and it does not require implants, special tools, or suture materials. Furthermore, it gives excellent results, with negligible pain, and rapid recovery without significant complications.

Level of evidence: 4.

Keywords: palatoplasty; pharyngoplasty; sleep disorders; soft palate; velopharyngeal function.

MeSH terms

  • Cleft Palate*
  • Constriction, Pathologic
  • Humans
  • Palate, Soft / surgery
  • Pharynx / surgery
  • Prospective Studies
  • Snoring* / etiology
  • Snoring* / surgery
  • Treatment Outcome