2023 Volume 48 Issue 1 Pages 61-68
After primary repair, approximately 90％ of patients with cleft palate gain sufficient velopharyngeal function for verbal communication. However, the function gradually deteriorates as patients get older due to enlargement of the velopharyngeal space. Conventional secondary procedures such as pharyngeal flap are often regarded as too invasive, and there is an unmet need among these patients who experience slight inconvenience during communication due to insufficient velopharyngeal function. There are reports from abroad in which fat grafting is performed for these patients, and a systematic review found that patients with mild to moderate incompetency are good candidates for this procedure. At the National Center for Child Health and Development, in 2019 we started a prospective study to evaluate the safety and efficacy of the procedure; one patient has completed the treatment and evaluation so far. Fat grafting is thought to be safely feasible and may be a promising alternative for patients with mild to moderate velopharyngeal incompetence.
