Posterior pharyngeal wall augmentation

Posterior pharyngeal wall augmentation is a useful technique in selected patients with velopharyngeal insufficiency who have a small central velopharyngeal gap. Options for augmenting this region include using posterior pharyngeal wall flaps to create bulk and implanting various materials to fill in the central deficiency. Autologous and nonautologous implant materials are available and may be implanted through an incision or directly injected into the posterior pharyngeal wall. Previously described materials for implantation include cartilage, fat, fascia, silicone, acellular dermis, polytetrafluoroethylene, and calcium hydroxyapatite. Patient evaluation and surgical techniques for posterior pharyngeal wall augmentation are described.