06/02/2026
Safely discharged today.
A complex secondary VPI case with significant posterior gap managed with bilateral buccal flap palatal lengthening โ and today, this young patient goes home stable and comfortable.
Behind every successful surgery is a silent, disciplined team.
Anesthesia. Nursing. OT staff. Post-operative care. Speech team.
Precision in theatre.
Vigilance in recovery.
Compassion throughout.
Grateful to my entire team for making challenging cases feel seamless.
Secondary VPI โ surgery
A challenging case of asymmetric short soft palate with a posterior velopharyngeal gap >20 mm.
Previously operated with conventional radical levator dissection.
Despite intervention, persistent VPI remained evident on nasoendoscopy six years later.
๐ Large posterior gap
๐ Inadequate palatal length
๐ Speech compromise
Decision: Palatal lengthening with bilateral buccal myomucosal flaps using an ACRP โno-touchโ philosophy โ respecting prior muscle repair and focusing on length rather than further radical dissection.
Postoperative outcome:
โ Posterior gap reduced from >20 mm to