{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:15:54Z","timestamp":1785212154129,"version":"3.55.0"},"reference-count":74,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T00:00:00Z","timestamp":1680048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Velopharyngeal insufficiency (VPI) is a controversial pathology with many surgical options.<\/jats:p><jats:p>\n          Objective\u2003To compare pharyngoplasty and retropharyngeal fat grafting and to build a prognostic tool to achieve perfect speech.<\/jats:p><jats:p>\n          Methods\u2003Retrospective observational cohort study of 114 patients operated for VPI from 1982 to 2019 in a single tertiary center. The instrumental assessment was made using an aerophonoscope and nasofibroscopy. The variables sex, age, genetic syndromes, and type of diagnosis were analyzed with logistic regression model adjusted with propensity score. To generalize results and to build a surgical predictive tool, a marginal analysis concludes the study.<\/jats:p><jats:p>\n          Results\u2003Among the patients (median [range] age 7 [4\u201348]), 63 (55.26%) underwent pharyngoplasty and 51 (44.74%) graft. The graft group had no complication, but it had a failure rate of 7.84%. The pharyngoplasty group had no failure, but one patient had postoperative obstructive sleep apnea. The marginal analysis demonstrated that age lower than 7 years, cleft lip and palate, absence of syndrome, and intermittent VPI were important predictive factors of good result regardless of surgical technique.<\/jats:p><jats:p>\n          Conclusions\u2003Without a statistical demonstration of the superiority of pharyngoplasty over graft, and in the uncertainty of literature background, our perfect-speech patient profile represents an important tool for a postoperative forecast of results in which, like in the Master Mind game, every feature has to be considered not individually but as a pattern of characteristics whose association contributes to the outcome.<\/jats:p>","DOI":"10.1055\/s-0043-1763501","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T23:41:10Z","timestamp":1680133270000},"page":"e351-e361","source":"Crossref","is-referenced-by-count":7,"title":["A Master Mind Game Code Algorithm Approach to Help Surgical Decision-Making between Retropharyngeal Fat Grafting and Pharyngoplasty for the Treatment of Velopharyngeal Incompetence"],"prefix":"10.1055","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8867-8769","authenticated-orcid":false,"given":"Chiara","family":"Suzzi","sequence":"additional","affiliation":[{"name":"Research Team ICAR, LIMM, CNRS, Montpellier University, Montpellier, France"},{"name":"Subintensive Care Unit, Montecatone Rehabilitation Institute, Imola (BO), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7204-4091","authenticated-orcid":false,"given":"Gianfranco","family":"Di Gennaro","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Gr\u00e6cia,\u201d Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Baylon","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic and Plastic Surgery, University Hospital of Montpellier, Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1705-2339","authenticated-orcid":false,"given":"Guillaume","family":"Captier","sequence":"additional","affiliation":[{"name":"Research Team ICAR, LIMM, CNRS, Montpellier University, Montpellier, France"},{"name":"Pediatric Orthopedic and Plastic Surgery, University Hospital of Montpellier, Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,3,29]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1055\/s-0031-1277717","article-title":"Types and causes of velopharyngeal dysfunction","volume":"32","author":"A W Kummer","year":"2011","journal-title":"Semin Speech Lang"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"S129","DOI":"10.4103\/0970-0358.57201","article-title":"Velo-pharyngeal dysfunction: Evaluation and management","volume":"42","author":"J L Marsh","year":"2009","journal-title":"Indian J Plast Surg"},{"issue":"04","key":"ref3","first-page":"413","article-title":"Velopharyngeal nomenclature: incompetence, inadequacy, insufficiency, and dysfunction","volume":"25","author":"J W Folkins","year":"1988","journal-title":"Cleft Palate J"},{"issue":"04","key":"ref4","first-page":"334","article-title":"Velopharyngeal dysfunction: recommendations for use of nomenclature","volume":"24","author":"R W Loney","year":"1987","journal-title":"Cleft Palate J"},{"issue":"03","key":"ref5","first-page":"19","article-title":"Velopharyngeal function and dysfunction","volume":"1","author":"D L Jones","year":"1991","journal-title":"Clin Commun Disord"},{"issue":"02","key":"ref6","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1055\/s-2007-979282","article-title":"Management of velopharyngeal insufficiency: development of a protocol and modifications of sphincter pharyngoplasty","volume":"23","author":"K C Sie","year":"2007","journal-title":"Facial Plast Surg"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"167","DOI":"10.3406\/psy.1966.27883","article-title":"Les troubles de la parole [Speech disorders]","volume":"66","author":"S Borel-Maisonny","year":"1966","journal-title":"Annee Psychol"},{"issue":"02","key":"ref8","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.jormas.2017.11.011","article-title":"Speech evaluation after intravelar veloplasty. 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V\u00e9loplasties et pharyngoplasties par lambeau pharyng\u00e9 \u00e0 p\u00e9dicule sup\u00e9rieur ou inf\u00e9rieur","volume":"108","author":"M P Vazquez","year":"2007","journal-title":"[Velopharyngeal sequels in labial-alveolar-velopalatine clefts. Veloplasty and pharyngoplasty using an inferior or superior pedicle pharyngeal flap] Rev Stomatol Chir Maxillofac"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/00006534-196804000-00005","article-title":"Construction of a dynamic muscle sphincter in cleft palates","volume":"41","author":"M Orticochea","year":"1968","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.bjps.2012.11.006","article-title":"Autologous fat transplantation to the velopharynx for treating persistent velopharyngeal insufficiency of mild degree secondary to overt or submucous cleft palate","volume":"66","author":"C Filip","year":"2013","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"06","key":"ref26","doi-asserted-by":"publisher","first-page":"E2046","DOI":"10.1002\/lary.29189","article-title":"Speech Outcomes After Sphincter Pharyngoplasty for Velopharyngeal Insufficiency","volume":"131","author":"A S Lam","year":"2021","journal-title":"Laryngoscope"},{"issue":"03","key":"ref27","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1597\/1545-1569_1992_029_0254_eotsp_2.3.co_2","article-title":"Evaluation of the sphincter pharyngoplasty","volume":"29","author":"J E Riski","year":"1992","journal-title":"Cleft Palate Craniofac J"},{"issue":"07","key":"ref28","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1097\/01.PRS.0000090720.33554.8B","article-title":"An outcome evaluation of sphincter pharyngoplasty for the management of velopharyngeal insufficiency","volume":"112","author":"A Losken","year":"2003","journal-title":"Plast Reconstr Surg"},{"issue":"08","key":"ref29","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1001\/archoto.2011.114","article-title":"Outcomes of sphincter pharyngoplasty and palatal lengthening for velopharyngeal insufficiency: a 10-year experience","volume":"137","author":"M P Carlisle","year":"2011","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"04","key":"ref30","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1597\/1545-1569_1990_027_0337_sftron_2.3.co_2","article-title":"Standardization for the reporting of nasopharyngoscopy and multiview videofluoroscopy: a report from an International Working Group","volume":"27","author":"K J Golding-Kushner","year":"1990","journal-title":"Cleft Palate J"},{"issue":"01","key":"ref31","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.smrv.2010.06.003","article-title":"Development of pediatric sleep questionnaires as diagnostic or epidemiological tools: a brief review of dos and don'ts","volume":"15","author":"K Spruyt","year":"2011","journal-title":"Sleep Med Rev"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.ijporl.2017.03.012","article-title":"Velopharyngeal insufficiency managed by autologous fat grafting in patients with aberrant courses of internal carotid arteries","volume":"96","author":"E Bois","year":"2017","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/S0094-1298(20)31069-5","article-title":"Facial recontouring with lipostructure","volume":"24","author":"S R Coleman","year":"1997","journal-title":"Clin Plast Surg"},{"issue":"04","key":"ref34","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.stomax.2007.06.014","article-title":"Les s\u00e9quelles v\u00e9lopharyng\u00e9es dans les fentes labioalv\u00e9olopalatov\u00e9laires. 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Crockett","year":"2014","journal-title":"Front Pediatr"},{"issue":"03","key":"ref51","doi-asserted-by":"crossref","first-page":"e34332","DOI":"10.1371\/journal.pone.0034332","article-title":"In search of the optimal surgical treatment for velopharyngeal dysfunction in 22q11.2 deletion syndrome: a systematic review","volume":"7","author":"N E Spruijt","year":"2012","journal-title":"PLoS One"},{"issue":"04","key":"ref52","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1597\/10-049","article-title":"Velopharyngeal dysfunction and 22q11.2 deletion syndrome: a longitudinal study of functional outcome and preoperative prognostic factors","volume":"49","author":"N E Spruijt","year":"2012","journal-title":"Cleft Palate Craniofac J"},{"issue":"05","key":"ref53","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1097\/SCS.0000000000003722","article-title":"Surgical Outcomes for Speech Surgery in 22q11.2 Deletion Syndrome: The Dilemma of Persistent Velopharyngeal Insufficiency After Pharyngeal Flap Operation","volume":"28","author":"R D Wagner","year":"2017","journal-title":"J Craniofac Surg"},{"issue":"03","key":"ref54","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1590\/2317-1782\/20152014145","article-title":"Relationship between velopharyngeal closure, hypernasality, nasal air emission and nasal rustle in subjects with repaired cleft palate","volume":"27","author":"R H Scarmagnani","year":"2015","journal-title":"CoDAS"},{"issue":"02","key":"ref55","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1597\/1545-1569_1999_036_0154_cbttop_2.3.co_2","article-title":"Comparison between two types of pharyngeal flap with regard to configuration at rest and function and speech outcome","volume":"36","author":"J Karling","year":"1999","journal-title":"Cleft Palate Craniofac J"},{"issue":"03","key":"ref56","first-page":"262","article-title":"The case for the inferiorly based posterior pharyngeal flap","volume":"15","author":"P Randall","year":"1978","journal-title":"Cleft Palate J"},{"issue":"06","key":"ref57","first-page":"1401","article-title":"Velopharyngeal surgery: a prospective randomized study of pharyngeal flaps and sphincter pharyngoplasties","volume":"110","author":"A Ysunza","year":"2002","journal-title":"Plast Reconstr Surg"},{"issue":"05","key":"ref58","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1597\/03-148.1","article-title":"Pharyngeal flap and sphincterplasty for velopharyngeal insufficiency have equal outcome at 1 year postoperatively: results of a randomized trial","volume":"42","author":"F Abyholm","year":"2005","journal-title":"Cleft Palate Craniofac J"},{"issue":"02","key":"ref59","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1177\/1055665619880056","article-title":"Marked Variation Exists Among Surgeons and Hospitals in the Use of Secondary Cleft Lip Surgery","volume":"57","author":"T J Sitzman","year":"2020","journal-title":"Cleft Palate Craniofac 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Therapeutic role in surgery of the palatine shelves]","volume":"90","author":"J Delaire","year":"1989","journal-title":"Rev Stomatol Chir Maxillofac"},{"issue":"02","key":"ref76","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.ijom.2012.09.022","article-title":"Influence of pharyngeal flap surgery on maxillary outgrowth in cleft patients","volume":"42","author":"I E Voshol","year":"2013","journal-title":"Int J Oral Maxillofac Implants"},{"issue":"04","key":"ref77","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00006534-198304000-00003","article-title":"The magnum procedure: surgical salvage of end-stage velopharyngeal incompetence","volume":"71","author":"J H Cochran Jr","year":"1983","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref78","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1097\/00006534-199402000-00007","article-title":"Pharyngeal flap revisions: flap elevation from a scarred posterior pharynx","volume":"93","author":"C M Barone","year":"1994","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref79","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/SAP.0b013e3181c71063","article-title":"Use of hemisphincter pharyngoplasty in the management of velopharyngeal insufficiency after pharyngeal flap: an outcome study","volume":"65","author":"W N Lin","year":"2010","journal-title":"Ann Plast Surg"}],"container-title":["International Archives of Otorhinolaryngology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1763501.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T23:37:45Z","timestamp":1682725065000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1763501"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,29]]},"references-count":74,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2023,4,28]]},"published-print":{"date-parts":[[2023,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1763501","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1809-9777","1809-4864"],"issn-type":[{"value":"1809-9777","type":"print"},{"value":"1809-4864","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,29]]}}}