Purpose: To examine the long-term outcomes for patients who have received a pharyngeal flap for velo-pharyngeal insufficiency (VPI). Method and Materials: Using the center’s craniofacial database, all patients that underwent a pharyngeal flap between January 1970 and December 2000, with at least one post-operative speech assessment between two and five years after surgery, were identified. Speech perceptive scores for hypernasality, hyponasality, and velopharyngeal competence from this time period were then compared with a sequence of more distant time periods, intermediate (five to eight years), long-term (eight to eleven years), and distant (eleven to fourteen years) after surgery. Summary of Results: 172 individual patients with pharyngeal flaps were identified as having post-operative data in the initial 2 to 5 year period. Of this group, 103 individuals had evaluations in the intermediate time period, 65 had evaluations in the long-term period, and 43 had evaluations in the distant period. No significant differences were noted for any of the three indices measured over time. Complications, which were minimal, were characterized and will be discussed. Conclusion: While a number of publications have shown the pharyngeal flap in the short-term post-operative period to be an effective procedure for the treatment of VPI, little long-term data is available, either for outcomes or complications. This work addresses this void and argues that the pharyngeal flap is a procedure that offers the patient a durable option in the treatment of VPI with minimal long-term complications.
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