{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:25:53Z","timestamp":1790504753497,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,12,14]],"date-time":"2017-12-14T00:00:00Z","timestamp":1513209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2018,3]]},"abstract":"\n Objective:<\/jats:title>\n Autologous fat grafting of the velopharynx has been well described for the treatment of velopharyngeal insufficiency (VPI), with most studies purporting it as a technique with low morbidity useful in the treatment of mild VPI. Prompted by 3 cases of obstructive sleep apnea (OSA) following fat grafting of the velopharynx, we undertook a review of the outcomes of this procedure at our unit.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective case series.<\/jats:p>\n <\/jats:sec>\n \n Participants:<\/jats:title>\n All patients who underwent autologous fat grafting for VPI at the Royal Children\u2019s Hospital Melbourne.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures:<\/jats:title>\n Preoperative nasendoscopy findings, perceptual speech assessment results, and rates of revisional surgery and complications.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Twenty-eight patients were included in the study. Three patients (11%) developed severe OSA requiring removal of the grafted fat. In a subanalysis of cleft patients, there was a reported improvement in hypernasality in 63% though only 25% had complete resolution of their hypernasality. Patients who had an improvement in speech were more likely to have a velopharyngeal gap of less than 0.5 cm\n 2<\/jats:sup>\n on preoperative nasendoscopy. All 3 patients who developed OSA had syndromes associated with hypotonia.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n This study raises serious concerns over the safety and efficacy of fat grafting for VPI. Overall, there was a relatively high complication rate with generally poor speech results in our series of patients. Stringent criteria should be used to select candidates for fat grafting, namely, a velopharyngeal gap less than 0.5 cm\n 2<\/jats:sup>\n and the absence of a syndrome associated with hypotonia.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/1055665617739002","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T13:03:16Z","timestamp":1518526996000},"page":"383-388","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Safety and Efficacy Concerns of Autologous Fat Grafting for Velopharyngeal Insufficiency"],"prefix":"10.1177","volume":"55","author":[{"given":"Yun S.","family":"Phua","sequence":"first","affiliation":[{"name":"Department of Plastic and Maxillofacial Surgery, Royal Children\u2019s Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Edmondson","sequence":"additional","affiliation":[{"name":"Department of Plastic and Maxillofacial Surgery, Royal Children\u2019s Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel J.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Speech Language Therapy, Royal Children\u2019s Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstie A.","family":"Macgill","sequence":"additional","affiliation":[{"name":"Department of Plastic and Maxillofacial Surgery, Royal Children\u2019s Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo P.","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Department of Plastic and Maxillofacial Surgery, Royal Children\u2019s Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A.","family":"Burge","sequence":"additional","affiliation":[{"name":"Department of Plastic and Maxillofacial Surgery, Royal Children\u2019s Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,12,14]]},"reference":[{"key":"bibr1-1055665617739002","first-page":"688","volume":"68","author":"Bicknell S","year":"2002","journal-title":"J Can Dent Assoc"},{"key":"bibr2-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000442"},{"key":"bibr3-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811411655"},{"key":"bibr4-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)32343-9"},{"key":"bibr5-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1177\/000348940111000213"},{"key":"bibr6-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31825b3ba9"},{"key":"bibr7-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050177"},{"key":"bibr8-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1597\/09-161"},{"key":"bibr9-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2012.11.006"},{"key":"bibr10-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182268e1b"},{"key":"bibr11-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000104515.51639.6B"},{"key":"bibr12-1055665617739002","volume-title":"Paper presented at: Craniofacial Society of Great Britain and Ireland Annual Conference","author":"Hall P"},{"key":"bibr13-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1597\/11-038"},{"key":"bibr14-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2011.08.001"},{"key":"bibr15-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-009-1157-7"},{"key":"bibr16-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199105000-00005"},{"key":"bibr17-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1597\/04-115.1"},{"key":"bibr18-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2012.03.005"},{"key":"bibr19-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1597\/09-024"},{"key":"bibr20-1055665617739002","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.61.8.1151"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1055665617739002","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1055665617739002","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1055665617739002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:22:56Z","timestamp":1777393376000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1055665617739002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,14]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1177\/1055665617739002"],"URL":"https:\/\/doi.org\/10.1177\/1055665617739002","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,14]]}}}