Update on injection augmentation pharyngoplasty in the treatment of velopharyngeal insufficiency.

PURPOSE OF REVIEW: Velopharyngeal insufficiency (VPI) refers to a structural defect resulting in incomplete closure between the soft palate and posterior pharyngeal wall, leading to inadequate speech and deglutition. Traditional surgical options for VPI include sphincter pharyngoplasty, pharyngeal flaps and palatoplasty. Although these procedures have been successfully used over the past several decades, they are associated with complications such as pain, bleeding, infection and obstructive sleep apnoea. They also require postoperative admission. Injection augmentation pharyngoplasty (IAP) is increasingly being viewed as a viable, less invasive surgical option for patients with mild to moderate VPI. RECENT FINDINGS: Both autologous fat and alloplastic synthetics have been used as injectable materials, with low morbidity and good speech outcomes. However, given the overall lack of standardization across studies, no single material has shown clear superiority. SUMMARY: IAP is a promising alternative to more invasive surgeries in the treatment of patients with mild to moderate VPI. The purpose of this review is to provide an overview of this approach, with an emphasis on its safety and efficacy.