There is not one single operative approach to surgical correction of VPI. The surgical approach typically depends on the size of the velopharyngeal opening, its location, and the cause. With diagnostic tools the surgeon is able to decide which technique should be used based on the anatomical situation of the individual. The goal of every operation is to achieve the best possible result with the technique assigned to each individual case, without causing upper airway obstruction and sleep apnea.Nowadays the procedure that is chosen the most from the palatoplasties is the pharyngeal flap or sphincter palatoplasty. Pharyngeal flap
When a pharyngeal flap is used, a flap of the posterior wall is attached to the posterior border of the soft palate. The flap consists of mucosa and the superior pharyngeal constrictor muscle. The muscle stays attached to the pharyngeal wall at the upper side (superior flap) or at the lower side (inferior flap). The function of the muscle is to obstruct the pharyngeal port at the moment that the pharyngeal lateral walls move towards each other. It is important that the width and the level of insertion of the flap are properly constructed, because if the flap is too wide, the patient can have problems with breathing through the nose, which can result in sleep apnea. Alternatively, a postoperative situation can be created with the same symptoms as before surgery. Some complications are possible; for example, the flaps width can change because of contraction of the flap.
Properties
Tallying is often referred to as "base 1", since only one mark – the tally itself – is needed. This is more formally referred to as a unary numeral system. Unlike base 2 or base 10, this is not a positional notation. Since the base 1 exponential function (1x) always equals 1, its inverse does not exist (which would be called the logarithm base 1 if it did exist). There are two ways to write the real number 1 as a recurring decimal: as 1.000..., and as 0.999.... 1 is the first figurate number of every kind, such as triangular number, pentagonal number and centered hexagonal number, to name just a few. In many mathematical and engineering problems, numeric values are typically normalized to fall within the unit interval from 0 to 1, where 1 usually represents the maximum possible value in the range of parameters. Likewise, vectors are often normalized into unit vectors (i.e., vectors of magnitude one), because these often have more desirable properties. Functions, too, are often normalized by the condition that they have integral one, maximum value one, or square integral one, depending on the application. Because of the multiplicative identity, if f(x) is a multiplicative function, then f(1) must be equal to 1. It is also the first and second number in the Fibonacci sequence (0 being the zeroth) and is the first number in many other mathematical sequences. The definition of a field requires that 1 must not be equal to 0. Thus, there are no fields of characteristic 1.