{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:26:03Z","timestamp":1790504763809,"version":"4.1.0"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T00:00:00Z","timestamp":1564099200000},"content-version":"vor","delay-in-days":451,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Plast Surg"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>\n          Introduction: Velopharyngeal insufficiency (VPI) is the inability to close the velopharyngeal sphincter during phonation and\/or feeding. VPI is clinically characterised by hypernasal speech and nasal regurgitation. In cases of severe VPI, pharyngoplasty is recommended. Cases of mild-to-moderate VPI can be treated with fat grafting of the posterior pharyngeal wall in addition to speech therapy. The lipofilling can also be useful after pharyngoplasty to improve the outcomes. Materials and Methods: Twenty-one patients (14 males and 7 females), ages 4\u201323 affected by mild-to-moderate VPI and treated with lipofilling were included in this retrospective study. The mean injected fat volume was 7.95 cc (median 6 cc, min 4 cc, max 20 cc and range 16 cc). The follow-up ranged from 6 to 60 months. The pre- and post-operative Borel\u2013Maisonny scores were compared using Wilcoxon test. Moreover, we performed a telephone survey with the aim to assess the parental perception on child's speech and quality of life after the surgical treatment. Results: Despite the small sample size, in this case series, we observed a statistically significant Borel\u2013Maisonny score improvement and a parental satisfaction rate of about 85%. Conclusions: The augmentation of the posterior pharyngeal wall in addition to speech therapy improved the Borel\u2013Maisonny score and the intelligibility of this case series of patients affected by mild-to-moderate VPI. In these patients, evaluated in a multidisciplinary approach, this technique allowed us to avoid major surgical procedures that would modify the anatomy of the velopharyngeal port. However, prospective comparative studies or randomised controlled trials could be useful to compare fat grafting with velopharyngoplasty techniques, with the aim to clarify indications and to define a specific treatment protocol.<\/jats:p>","DOI":"10.4103\/ijps.ijps_183_17","type":"journal-article","created":{"date-parts":[[2018,10,29]],"date-time":"2018-10-29T04:52:37Z","timestamp":1540788757000},"page":"145-154","source":"Crossref","is-referenced-by-count":13,"title":["Autologous fat grafting in the treatment of velopharyngeal insufficiency: Clinical outcomes and treatment tolerability survey in a case series of 21 patients"],"prefix":"10.1055","volume":"51","author":[{"given":"Renzo","family":"Panizza","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ghiglione","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico Maria","family":"Zingarelli","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Massa","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Carlini","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Arnoldi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio Pini","family":"Prato","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Scarrone","sequence":"additional","affiliation":[{"name":"Department of Operating Theatre Management, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Vaccarella","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2019,7,26]]},"reference":[{"key":"key-10.4103\/0970-0358.244352-1","first-page":"1277","volume-title":"Rhinopharyngeal autologous fat injection for treatment of velopharyngeal insufficiency in patients with cleft palate","author":"Piotet","year":"2015","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"key-10.4103\/0970-0358.244352-2","first-page":"977","volume-title":"Treatment of velopharyngeal insufficiency by autologous fat injection","author":"Leuchter","year":"2010","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"key-10.4103\/0970-0358.244352-3","first-page":"1404","volume-title":"Autologous fat transfer in velopharyngeal insufficiency: Indications and results of a 25 procedures series","author":"Leboulanger","year":"2011","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"key-10.4103\/0970-0358.244352-4","first-page":"284","volume-title":"Autologous fat injection combined with palatoplasty and pharyngoplasty for velopharyngeal insufficiency and cleft palate: Preliminary experience","author":"Cao","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"key":"key-10.4103\/0970-0358.244352-5","first-page":"337","volume-title":"Autologous fat transplantation to the velopharynx for treating persistent velopharyngeal insufficiency of mild degree secondary to overt or submucous cleft palate","author":"Filip","year":"2013","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"key-10.4103\/0970-0358.244352-6","first-page":"S190","volume-title":"Effectiveness and safety of autologous fat grafting to the soft palate alone","author":"Boneti","year":"2015","journal-title":"Ann Plast Surg"},{"key":"key-10.4103\/0970-0358.244352-7","first-page":"365","volume-title":"Regenerative approach to velopharyngeal incompetence with fat grafting","author":"Mazzola","year":"2015","journal-title":"Clin Plast Surg"},{"key":"key-10.4103\/0970-0358.244352-8","first-page":"401","volume-title":"Treatment of velopharyngeal insufficiency by pharyngeal and velar fat injections","author":"Cantarella","year":"2011","journal-title":"Otolaryngol Head Neck Surg"},{"key":"key-10.4103\/0970-0358.244352-9","first-page":"168","volume-title":"Retropharyngeal autologous fat transplantation for congenital short palate: A nasometric assessment of functional results","author":"Dejonckere","year":"2001","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"key-10.4103\/0970-0358.244352-10","first-page":"352","volume-title":"Velopharyngeal sequels in labial-alveolar-velopalatine clefts.Pharyngoplasty by pharynx Lipostructure\u00ae","author":"Bardot","year":"2007","journal-title":"Rev Stomatol Chir Maxillofac"},{"key":"key-10.4103\/0970-0358.244352-11","first-page":"38","volume-title":"Identification and assessment of velopharyngeal inadequacy","author":"Conley","year":"1997","journal-title":"Am J Otolaryngol"},{"key":"key-10.4103\/0970-0358.244352-12","first-page":"394","volume-title":"A comparison of nasendoscopy and multiview videofluoroscopy in assessing velopharyngeal insufficiency","author":"Lam","year":"2006","journal-title":"Otolaryngol Head Neck Surg"},{"key":"key-10.4103\/0970-0358.244352-13","first-page":"932","volume-title":"Evaluation of VPI-assessment with videofluoroscopy and nasoendoscopy","author":"Sommerlad","year":"2005","journal-title":"Br J Plast Surg"},{"key":"key-10.4103\/0970-0358.244352-14","doi-asserted-by":"crossref","unstructured":"Gersuny R. The classic reprint. Concerning a subcutaneous prosthesis: Robert Gersuny. (Uber eine subcutane Prothese. Zeitschrift f. Heilkunde Wien u Leipzig 21:199, 1900.). Translated from the German by Miss Rita Euerle. Plast Reconstr Surg 1980;65:525-7. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/6987692.","DOI":"10.1097\/00006534-198004000-00025"},{"key":"key-10.4103\/0970-0358.244352-15","first-page":"19","volume-title":"Teflon injection pharyngoplasty","author":"Bluestone","year":"1968","journal-title":"Cleft Palate J"},{"key":"key-10.4103\/0970-0358.244352-16","first-page":"254","volume-title":"Retropharyngeal implantation of silicone gel pillows for velopharyngeal incompetence","author":"Brauer","year":"1973","journal-title":"Plast Reconstr Surg"},{"key":"key-10.4103\/0970-0358.244352-17","first-page":"119","volume-title":"Proplast as a pharyngeal wall implant to correct velopharyngeal insufficiency","author":"Wolford","year":"1989","journal-title":"Cleft Palate J"},{"key":"key-10.4103\/0970-0358.244352-18","first-page":"269","volume-title":"The use of injectable collagen to correct velopharyngeal 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arteries","author":"Bois","year":"2017","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"key-10.4103\/0970-0358.244352-27","first-page":"806e","volume-title":"Internal carotid artery variations in velocardiofacial syndrome patients and its implications for surgery","author":"Baek","year":"2013","journal-title":"Plast Reconstr Surg"},{"key":"key-10.4103\/0970-0358.244352-28","first-page":"153","volume-title":"Selection of donor site for fat grafting and cell isolation","author":"Li","year":"2013","journal-title":"Aesthetic Plast Surg"},{"key":"key-10.4103\/0970-0358.244352-29","first-page":"391","volume-title":"In search of improved fat transfer viability: A quantitative analysis of the role of centrifugation and harvest site","author":"Rohrich","year":"2004","journal-title":"Plast Reconstr Surg"},{"key":"key-10.4103\/0970-0358.244352-30","first-page":"547","volume-title":"Autologous fat grafting in the breast: Critical points and technique 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