What Is Pharyngeal Flap Surgery?

What Is Pharyngeal Flap Surgery?

A pharyngeal flap is a common secondary surgery for VPI. Here is what it involves.

Pharyngeal flap surgery is a procedure that creates a bridge of tissue from the back of the throat to the soft palate to help close the gap during speech.

• How it works:
• A flap of tissue is raised from the posterior pharyngeal wall (back of the throat)
• The flap is attached to the soft palate
• This creates a central obstruction that blocks air from escaping through the nose
• Air flows around the sides of the flap (lateral ports) for nasal breathing
• During speech, the palate lifts and seals against the flap

• When is it used?
• Moderate to severe VPI that has not responded to speech therapy
• Large gap between the palate and throat
• A short palate that cannot reach the back of the throat

• The procedure:
• Performed under general anesthesia
• Takes 1–2 hours
• Hospital stay: 1–2 nights
• The throat may be sore for 1–2 weeks
• Soft diet for 2 weeks after surgery

• Risks:
• Snoring or obstructed breathing at night (usually temporary)
• Hyponasal speech (too little air through the nose)
• Difficulty blowing the nose
• Fistula formation (rare)

• Outcomes:
• 80–90% achieve significant speech improvement
• Most children achieve normal or near-normal speech
• Snoring usually improves over time as the tissues settle

Clinical Guidance

A pharyngeal flap creates a bridge from the back of the throat to the palate to treat VPI. It is effective for most patients with moderate to severe VPI. Temporary snoring and hyponasal speech are common side effects that usually improve.