Edwar Alvarez Md, Romaisa Shamim Khan, David Alvarez Md, Andrea Iñiguez Md, Muhammad Daiem.
Third Generation Veloplasty: Elongation of the Soft Palate, a New Concept and Technique.
Pak J Plastic Surg Jan ;08(2):64-8.

Background: Adequate reconstruction of the soft palate to achieve quality of phonation is one of the main objectives of cleft palate repair. Even with adequate repair, the soft palate may remain short, leading to Velopharyngeal Insufficiency. In such cases lengthening is achieved by sacrificing other important anatomical structures. Objective: We present a new technique in the reconstruction of the soft palate that elongates it in an efficient way providing adequate sufficiency and uvular competence, without sacrificing other palatal structures. Methods: During a five-year period, this technique was applied to a total of 731 patients, 437 in primary repairs and 294 in secondary or revision cases. All patients were subjected to a quantitative analysis with the "Alvarez Scale" or Speech Score both before and after surgery. Results: There was a notable improvement in our series in the prevention and treatment of Velopharyngeal insufficiency (VPI). There was a gain of one to two points (over fifteen) in improvement as compared to what the revision group had in their preoperative evaluation. Conclusion: In our experience, the Third Generation Veloplasty (TGV) is more effective in improving the velopharyngeal function than the first generation Veloplasty (OR = 2.76) Keywords | Velopharyngeal insufficiency (VPI), First Generation Veloplasty (FGV), Second Generation Veloplasty (SGV), Third Generation Veloplasty (TGV), Uvular insufficiency (UI), Uvular incompetence (UIc), Speech Score (SS)

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