Secondary Superiorly Based Pharyngeal Flap Following Complete Pharyngeal Flap Dehiscence

Velopharyngeal insufficiency following palatoplasty often requires surgical intervention, with the superiorly based pharyngeal flap as a commonly used technique. Flap dehiscence is a clinically significant complication, and strategies for delayed revision remain unclear. The authors report a case of successful secondary superiorly based pharyngeal flap after complete dehiscence, in which early revision was deferred due to comorbidity. After limited improvement with speech therapy, delayed revision using the same donor site was performed. Speech outcomes showed marked improvement with adequate velopharyngeal competence and no airway compromise. Secondary superiorly based pharyngeal flap may be a feasible option when guided by careful preoperative evaluation.