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ULTIMO FASCICOLOJOURNAL OF NEUROSURGICAL SCIENCES

Rivista di Neurochirurgia


Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
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Journal of Neurosurgical Sciences 1998 Marzo;42(1):51-5

 CASE REPORTS

A possible seque­la of trans­oral ­approach to the upper cer­vi­cal spine. Velopharyngeal incom­pe­tence

Cantarella G. 1, Mazzola R. F. 2, Benincasa A. 1

1 Clinic ORL I IRCCS Ospedale Maggiore Policlinico, University of Milan, Italy;
2 School of Specialization in Maxillofacial Surgery, University of Milan, Italy

The ­authors ­describe a case of veloph­a­ryn­geal incom­pe­tence (VPI), as a con­se­quence to the neu­ro­sur­gi­cal treat­ment for a com­plex mal­for­ma­tion of the cra­nio-spi­nal junc­tion. A 61-year-old woman under­went a trans­oral-trans­ve­lar sur­gi­cal ­approach for odon­toid resec­tion. One month later sur­gi­cal fix­a­tion of the pos­te­ri­or spine with autol­o­gous iliac bone graft was per­formed. Following these oper­a­tions the ­patient pre­sent­ed a ­marked alter­a­tion of ­speech intel­leg­ibil­ity due to hyper­na­sal voice res­o­nance and ­through inca­pa­bil­ity to artic­u­late the oral pho­nemes cor­rect­ly. She also com­plained of nasal regur­gi­ta­tion of ­fluids and sol­ids while swal­low­ing. She under­went a clin­i­cal phon­i­at­ric assess­ment of voice and ­speech. Videonasopharyn­gos­co­py ­allowed us to ­inspect the veloph­a­ryn­geal sphinc­ter and to show clear­ly the type and mor­phol­o­gy of its clo­sure ­defect. Correction of VPI was ­achieved by means of a veloph­a­ryn­go­plas­ty (pha­ryn­geal flap), in spite of tech­ni­cal dif­fi­cul­ties due to local scar­ring and to a prob­le­mat­ic expo­sure of the sur­gi­cal field.

lingua: Inglese


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