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https://revistacefac.org.br/article/doi/10.1590/1982-0216/20252757625
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Analysis of the clinical-epidemiological profile of patients with cleft palate referred for prosthetic treatment of velopharyngeal insufficiency

Análise do perfil clínico-epidemiológico de pacientes com fissura palatina encaminhados para o tratamento protético da insuficiência velofaríngea

Kharinne Rachel Sá Vettorazzo; Maria Inês Pegoraro-Krook

http://dx.doi.org/10.1590/1982-0216/20252757625 Revista CEFAC, vol.27, n5, e7625, 2025
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Abstract

Purpose: to identify the number of patients referred for prosthetic treatment of velopharyngeal insufficiency at the Hospital for Rehabilitation of Craniofacial Anomalies of the Universidade de São Paulo (HRAC/USP) and investigate their clinical and epidemiological profile.

Methods: a retrospective study using secondary data from the medical records of patients treated at the Hospital for Rehabilitation of Craniofacial Anomalies with the Universidade de São Paulo (HRAC/USP) between 1990 and 2023, with indications for palatal prosthesis. The study collected clinical and demographic information, prosthetic and surgical history, and treatment data, and performed descriptive statistical analysis.

Results: the main indication criterion was a wide velopharyngeal gap with low pharyngeal mobility (79-80%). The average age at insertion ranged from 13 to 36 years, depending on the etiological group. Treatment completion rates ranged from 75% to 100%. Orthodontic integration was not feasible in 76-81% of congenital cases, but feasible in those without cleft palate. Speech therapy was performed in 72-82% of cases. Spontaneous velopharyngeal closure occurred in up to 6%, and secondary surgery was required in up to 11%.

Conclusion: patients with velopharyngeal dysfunction have distinct clinical profiles and needs depending on the etiology, requiring individualized protocols. Patients with congenital clefts require longer treatment, while those without clefts can begin prosthetic rehabilitation earlier. These findings reinforce the importance of specific strategies aimed at effective and personalized care.

Keywords

Velopharyngeal Insufficiency; Palatal Obturators; Cleft Palate

Resumo

Objetivo:  levantar o número de pacientes encaminhados para tratamento protético da insuficiência velofaríngea no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (HRAC/USP) e investigar seu perfil clínico-epidemiológico.

Métodos:  estudo retrospectivo com dados secundários de prontuários de pacientes atendidos no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (HRAC/USP) entre 1990 e 2023, com indicação de prótese de palato. Foram coletadas informações clínicas, demográficas, histórico protético e cirúrgico, além de dados sobre o tratamento. Foi realizada análise estatística descritiva.

Resultados:  o principal critério de indicação foi gap velofaríngeo amplo com baixa mobilidade faríngea (79-80%). A idade média para instalação variou entre 13 e 36 anos, conforme o grupo etiológico. A conclusão do tratamento variou entre 75% a 100%. A integração ortodôntica foi inviável em 76-81% dos casos congênitos e viável nos sem fissura. A fonoterapia foi realizada em 72-82% dos casos. Fechamento velofaríngeo espontâneo ocorreu em até 6% e cirurgia secundária foi necessária em até 11%.

Conclusão:  pacientes com disfunção velofaríngea apresentam perfis clínicos e necessidades distintas dependendo da etiologia, exigindo protocolos individualizados. Pacientes com fissuras congênitas requerem tratamento mais prolongado, enquanto aqueles sem fissuras podem iniciar a reabilitação protética mais precocemente. Esses achados reforçam a importância de estratégias específicas voltadas para um cuidado eficaz e personalizado.

Palavras-chave

Insuficiência Velofaríngea; Obturadores Palatinos; Fissura Palatina

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Submetido em:
06/08/2025

Aceito em:
12/09/2025

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