Pharyngeal Bulb Reduction Program in Individuals with Cleft Palate

Abstract

ObjectivesTo describe a pharyngeal bulb reduction program (PBRP) aimed at decreasing the size of the velopharyngeal gap in individuals with repaired cleft palate presenting hypodynamic velopharynx, and to evaluate the effect of the PBRP on pharyngeal bulb dimensions.MethodsThirteen patients (6 females and 7 males; mean age = 28 years) with repaired cleft palate and hypodynamic velopharynx, who demonstrated normal speech using a pharyngeal bulb, participated in the study. The PBRP lasted two weeks and consisted of sequential pharyngeal bulb reductions during nasoendoscopy combined with intensive speech therapy. After each bulb reduction, measurements of bulb length, width, area, volume, and the prosthesis weight (pre-/post-PBRP) were obtained.ResultsAt the end of the PBRP, reductions in bulb dimensions were observed (length: -32.13%, width: -47.26%, area: -61.41%, and volume: -52.80%), as well as a decrease in prosthesis weight (-21.12%).Conclusions"In PBRB, the reduction in the dimensions of the pharyngeal bulb, combined with intensive speech therapy, proved effective in stimulating velopharyngeal mechanism movements during speech, leading to a consequent reduction in the size of the velopharyngeal gap. Following the PBRB procedure, reductions in the width and length of the bulb were observed, creating more favorable conditions for performing secondary surgery aimed at correcting velopharyngeal insufficiency."

Keywords: cleft palate; prosthetics; speech therapy; velopharyngeal disfunction.