Introduction
The pharynx is an important muscular tube that is a passageway for air and food between the nasal cavity, mouth, larynx, and esophagus. It has a significant role in each system. For example, the respiratory system helps to humidify and filter the air; the digestive system helps with swallowing to prevent liquids from entering the airway. Overall, it plays a crucial role in ensuring proper functions of the respiratory and digestive systems. Any disorders affecting the pharynx may require medical attention. Pharyngoplasty is a surgical procedure that helps to prevent nasal airflow interruption when an individual speaks and helps improve speech clarity.
What Is Pharynx and Its Functions?
Pharynx is a funnel-shaped muscular pathway that connects the mouth and nose to the esophagus and larynx. It lies in the middle of the neck and runs from the bottom of the skull, measuring approximately 4.5 inches. It plays an important role, which is mentioned below.
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Helps to carry air to the respiratory system.
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It helps the digestive system by delivering food and liquids.
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It equalizes the pressure in the ears and the external atmosphere.
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It helps drain excess fluid from the ears.
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It ensures the food passes only via the food passage.
The pharynx has an interesting anatomy, comprising three parts:
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Nasopharynx - The topmost part of the pharynx connects the throat to the nasal cavities, enabling air passage.
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Oropharynx - The middle part connects the throat to the mouth or oral cavity. It helps the passage of air, food, and fluids.
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Laryngopharynx - The bottom part of the throat lies near the larynx and regulates air passage to the lungs and fluids to the esophagus.
What Is Pharyngoplasty?
Pharyngoplasty is a surgical procedure to alter the shape and function of the soft palate and the areas around the pharynx. A few children born with birth defects like cleft palates may acquire a nasal tone to their voice. The soft palate may be short, and air escapes through the nose while speaking. Pharyngoplasty reduces the space behind the palate, so there is less escape of air when an individual speaks. Therefore, children with nasal speech can benefit from pharyngoplasty.
What Are the Types of Pharyngoplasty?
Pharyngoplasty is of different types based on the type and site of surgery. Some of them are mentioned below.
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Pharyngeal flap (PF).
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Sphincter pharyngoplasty (SP).
What Is Sphincter Pharyngoplasty?
Generally, the soft palate and pharynx must work together to close the nasal cavity and control the airflow through the mouth to produce speech sounds. Patients suffering from velopharyngeal insufficiency may have inadequate valve closure, leading to nasal speech and speaking difficulties. Sphincter pharyngoplasty is a surgical procedure to treat insufficiency and improve speech in affected individuals.
How Is Sphincter Pharyngoplasty Performed?
In this procedure, the surgeon uses tissues from the back of the throat to create a sphincter that helps improve the closure of the velopharyngeal valve, thereby reducing nasal airflow while speaking. The procedure is performed under general anesthesia, and an incision is made in the back of the throat to access the soft palate and pharynx. Next, the surgeon creates a sphincter with the tissues from the back of the throat to improve the closure of the velopharyngeal valve during speech. The exact technique is altered according to the need of the patient and the preference of the surgeon. For example, the procedure may include suturing the tissues to create a ring-like structure that helps reduce nasal airflow.
After the procedure, the patient must follow specific post-operative instructions, like avoiding certain foods and physical activities, to ensure proper healing. The duration of recovery and overall success of the procedure may vary with various factors like age, the severity of the condition, and the healing process.
What Are the Indications of Sphincter Pharyngoplasty?
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Sphincter pharyngoplasty treats individuals with conditions like speech therapy or pharyngeal flaps, which are inadequately addressed.
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The procedure is performed in children over five or six years old who have difficulty speaking after undergoing speech therapy.
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Patients with varied anatomical features like wide gaps between the soft palate and pharynx or a lack of tissue for pharyngeal flaps are recommended for sphincter pharyngoplasty.
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Patients undergo speech assessment before finalizing the requirements for sphincter pharyngoplasty.
The surgeon finalizes the procedure, and may vary according to the case. It involves a multidisciplinary approach, which includes a speech pathologist, a plastic surgeon, and ENT (ear, nose, and throat) specialist.
What Are the Contraindications of Sphincter Pharyngoplasty?
The procedure may only be suitable for some individuals. Some of the contraindications are mentioned below.
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Severe medical conditions could increase the risk of surgical complications, and anesthesia (a numbing agent) may sometimes be contraindicated.
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Children with less weight can not be operated on.
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Patients suffering from active infections in the oral and pharyngeal areas must treat the infection before proceeding with the surgery.
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Patients who had previous surgeries on the pharynx or palate may not be ideal for surgery.
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In patients with less tissue in the affected area, there may be difficulty in closing the flap.
What Are the Benefits of Sphincter Pharyngoplasty?
Sphincter pharyngoplasty improves the overall health of an individual. The procedure is minimally invasive and causes less scarring. It has a shorter recovery time and increases the confidence of an individual. In addition, it improves the speech clarity of an individual and reduces nasal flow.
Conclusion
Sphincter pharyngoplasty is a surgical procedure that chiefly aims to treat velopharyngeal insufficiency, which affects speech. The procedure involves using tissues from the back of the throat to create a sphincter. It helps to reduce nasal airflow when an individual speaks and helps boost the patient's confidence. The minimally invasive procedure causes less scarring and is an effective treatment for velopharyngeal insufficiency. It improves the overall quality of life and enhances improved speech. However, post-surgery follow-up may be required to understand the prognosis and outcomes of the procedure.
