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Combined Sphincter pharyngoplasty for speech correction and rhBMP-2 surgery for reconstruction of alveolar cleft

24/9/2014

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A 26-year-old man from Lucknow, with unilateral cleft lip and palate came to our hospital for expert cleft management. He was previously operated elsewhere for cleft lip and palate deformity. He had a nasal sounding speech and cleft in the alveolar bone (teeth-bearing jaw bone) in the right upper jaw. 

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed a combined sphincter pharyngoplasty & rhBMP-2 surgery. Cleft individuals have hypernasality due to escape of air through the nose during speech. This is called velopharyngeal incompetence and is corrected by pharyngoplasty. Dr. Balaji created a dynamic sphincter by surgically rearranging the palatopharyngeus muscles.  Due to the huge alveolar cleft in the right upper jaw, the right side of his nose appeared collapsed. Dr. Balaji employed the advanced rhBMP-2 technology to completely close the bone defect. This miracle protein stimulates the body’s own cells to form new bone at the site it’s placed ultimately healing the gap. This revolutionary technology avoids a second surgery for grafting bone from the rib or hip. 
Preoperative view showing depressed nasal base in right side due to huge alveolar cleft defect
Intraoral view showing altered palatopharyngeal muscles attachment affecting speech
Palatopharyngeal muscle detached for its different position and approximated into correct position on left side
Palatopharyngeal muscle detached for its different position and approximated into correct position on right side
Huge alveolar cleft defect on right side was exposed surgically
Miracle protein rhBMP-2 was placed in the alveolar cleft defect region to induce new bone formation
The video shows the new dynamic velopharyngeal sphincter action and a positive suction test indicating successful correction of velopharyngeal incompetence.  
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Successful sphincter pharyngoplasty for speech correction in cleft patient

9/6/2014

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A 12-year-old boy born with isolated cleft palate was brought to our hospital by his parents for surgical speech correction. He was previously operated elsewhere multiple times for his cleft palate defect. He had a nasal twang in his speech. This condition is called velopharyngeal incompetence that occurs in cleft children due to escape of air through the nose while speaking.

Maxillofacial Surgeon Dr. S.M. Balaji expertly performed a dynamic sphincter pharyngoplasty surgery wherein the palato-pharyngeal muscles were criss-crossed to correct the velopharyngeal incompetence. The video shows the new dynamic velopharyngeal sphincter action and a positive suction test indicating successful correction of velopharyngeal incompetence.  
During procedure soft palate muscles were surgically aligned
Surgical repositioning of the palato-pharyngeal muscles to correct VPI
Criss-cross correction of the soft palate musculature to enhance the speech
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