Does your voice sound nasal? Let's talk about pharyngoplasty!

Do you sometimes feel like others have a hard time understanding you when you speak? Does your voice sound nasal and unclear? Or do you or someone in your family have a problem with snoring or suffocating during sleep (sleep apnea)? Today we are going to talk about a special surgery that can be a solution to such conditions.

Simply put, what is Pharyngoplasty?

Pharyngoplasty is a surgical procedure that changes the shape and function of the soft palate and pharynx. Think about it, this surgery is mainly done to stop air from coming out of your nose when you talk. Doctors call this condition velopharyngeal insufficiency (VPI) . If your VPI makes your voice sound nasal (hypernasality) and makes it difficult for others to understand what you are saying, your doctor may recommend this surgery. In addition, a different type of surgery is also used to treat sleep apnea , a condition that causes adults to stop breathing during sleep.

Who needs pharyngoplasty surgery?

This surgery is most often needed for children who are born with a cleft palate. We call this Cleft Palate . This is a condition that is also seen in our country. Even after surgery to repair the cleft palate, about one-third (1/3) of some children may develop VPI, which means that their voice comes out of their nose. That is when Pharyngoplasty surgery is needed. Apart from that, children and adults may need this surgery for several other reasons.

• Conditions such as cerebral palsy .
• Genetic conditions such as Down syndrome and DiGeorge syndrome .
• Receiving radiation therapy for cancer of the throat and nose.
• After adenoidectomy or tonsillectomy .
• Stroke .
• Tumors in the brain or skull.

What are the main types of pharyngoplasty surgery?

There are several main types of this surgery. It depends on the problem you have. Let's see what they are.

What happens during the surgery?

All pharyngoplasty surgeries are performed under general anesthesia . This means that you or your child will not feel anything during the surgery and will be completely asleep. The surgery usually takes about two hours. The procedure varies slightly depending on the type of surgery.

Lateral Pharyngoplasty

This is done for sleep apnea. Here, the tissue on the roof of the mouth and on either side of the throat is removed and repositioned to widen the airway. If your tonsils have not already been removed, they may be removed at the same time as this surgery.

Pharyngeal flap

This is done for VPI. Here, a flap of tissue is taken from the back of the throat and sewn to the roof of the mouth. These stitches will dissolve over time. This flap of tissue closes the gap between the roof of the mouth and the throat. However, two small openings (lateral ports) are left on either side of the flap to allow breathing through the nose.

Sphincter Pharyngoplasty

This is another type of surgery for VPI. In this, two pieces of tissue are taken from behind the tonsils and sewn together across the back of the throat. This also narrows the gap behind the upper palate, preventing air from flowing through the nose when speaking. This leaves a port for breathing through the nose.

What can you expect after surgery?

You will usually stay in the hospital for one to three days after surgery. You or your child may experience the following:

• A slightly bloody discharge from the mouth or nose.
• Nasal congestion.
• Sore throat and neck. This can make it a little difficult to swallow.

However, very rarely (about 1 in 20 people), a nasopharyngeal airway may need to be placed to help you breathe until the swelling goes down.

What are the benefits and risks of this surgery?

The main advantages are:

• Breathing better.
• Voice clarity.
• Reduction in sleep apnea symptoms.

Risks and complications: Sometimes VPI (voice box) can persist after surgery. Also, some people who have VPI surgery may develop new snoring and sleep apnea. However, most of the time, this snoring will subside over time. Your doctor may order a sleep study (polysomnography) six months after surgery to check for sleep apnea. If VPI persists or sleep apnea develops, your doctor may perform another minor surgery. This involves making the ports in your throat larger or smaller.

How long does it take to heal?

Recovery time varies from person to person. However, you or your child will likely need to take about a week off from school or work to rest. It is very important to follow your doctor's instructions carefully during your recovery. These instructions may include:

• Keep your head elevated when sleeping or lying down.
• Eat only liquid foods or a soft food diet for one to three weeks.
• Avoid heavy lifting and strenuous activities for a while.
• Take the antibiotics exactly as prescribed to prevent infection.
• Use painkillers correctly.
• Participate in speech therapy.
• Suck on ice cubes for a sore throat.

When to see a doctor

If you or your child experience one or more of the following symptoms , see your doctor immediately.

• Dehydration or loss of appetite.
• Signs of an infection, such as fever, or foul-smelling discharge from the nose/mouth.
• Sleep disorders, especially conditions like sleep apnea.

Pharyngoplasty Sinhala, nasal voice, VPI, sleep apnea, cleft palate, cleft palate, throat surgery