Use of porous polyethylene implant for augmentation of the posterior pharynx in young adult patients with borderline velopharyngeal insufficiency.

In the current study, we evaluated the efficiency of using porous polyethylene implant to correct velopharyngeal insufficiency (VPI) in young adult patients. Ten male patients with VPI, aged 21 to 27 years, underwent posterior pharyngeal wall augmentation with porous polyethylene implant. The evaluations for VPI on all patients in the study included speech evaluation of nasality and articulation, mirror test, nasopharyngoscopy, and magnetic resonance (MR) imaging. Evaluation of the methods for correcting VPI was done preoperatively and 6 months after surgery, and the results were compared. According to preoperative speech evaluation, 7 patients had severe hypernasal speech and 3 patients had moderate hypernasal speech. Follow-up evaluations demonstrated that 7 patients had normal speech without hypernasal resonance. Although all patients had nasal escape on mirror test preoperatively, only 2 had nasal escape postoperatively. When the preoperative and postoperative results of the Multi-Dimensional Voice Programme were analyzed, there was a statistically significant improvement in all parameters. The distance between the posterior pharyngeal wall and the velum during phonation observed preoperatively had disappeared in the postoperative period in all of the patients' sagittal-plane MR scans. In the axial views of the MR scans, the velopharyngeal gap area calculated preoperatively was reduced in the postoperative period. We conclude that posterior pharyngeal wall augmentation with porous polyethylene implant is an effective method in the correction of mild VPI in adult patients.