Pharyngeal Flap Form

INDICATIONS FOR A PHARYNGEAL FLAP
Despite an adequate palate repair, a small number of children may have difficulty with their speech. The soft palate and pharyngeal muscles should work together to form a seal, which closes off the mouth from the nose. This prevents air from escaping through the nose during speech. You may have noticed a nasal quality to your child’s speech, particularly with /p/ and /b/ sounds. This may mean that air is leaking through the nose during speech and that the muscles are not functioning properly. This is called velopharyngeal insufficiency, or VPI.

ABOUT THE SURGERY
A pharyngeal flap is a surgical procedure to correct or enhance the quality of your child’s speech. This is usually done between the ages of 4-6 years of age. Muscle tissue is transferred from the back of the throat or pharynx to the palate in order to narrow the nasal opening. This should enable your child to have a more normal sounding voice and increase his/her communication skills.

LENGTH OF SURGERY AND HOSPITAL STAY
The operation usually takes approximately 2 hours. The first 24 hours after surgery, your child will be monitored closely. An orange tube in the nose will help with breathing as swelling occurs. The swelling and nasal blockage may cause some snoring. This is uncomfortable but gradually resolves. Your child will be in the hospital 1-2 days.

PAIN MANAGEMENT
Pain medication can be given every 4-6 hours as needed. You will be given a prescription.

DIET
Your child will have an IV in until fluids can be tolerated by mouth. After that a soft diet is best for 3 weeks. That may include: soup, yogurt, mashed fruits and vegetables, scrambled eggs, jello, ice cream, pudding, mashed potatoes or food that has been processed or blended.

DO NOT USE A STRAW
AVOID FOODS THAT WILL SCRATCH THE THROAT FOR 3 WEEKS; such as raw fruits and vegetables.

AFTER SURGERY
There are no restrictions in physical activity. Your child may return to school when you feel he/she is ready. Your child may snore after the surgery – this is normal, and usually improves as the swelling diminishes. You may notice an improvement in speech during the first week. Speech therapy can begin 4-6 weeks after surgery.

FOLLOW-UP APPOINTMENT
After surgery call 410-955-9466 to make a Monday appointment for approximately 2-3 weeks after the operation. This appointment will be followed by a Cleft Clinic visit 6-8 weeks after the surgery to assess the results of the surgery. The need for speech therapy will be determined at that time. Call 410-955-9466 to make that appointment or discuss it with Kim Seifert, R.N.

CONTACT NUMBERS
During office hours, if you notice significant bleeding, persistent temperature (greater than 101 degrees), or difficulty with breathing or eating during office hours, call your plastic surgeon. Dr. Craig Vander Kolk may be reached at 410-955-2136. Dr. Richard Redett may be reached at 410-955-9475. After office hours call 410-955-6070 and have the plastic surgery resident on call paged.