Phoniatric speech Evaluation after Velopharyngoplasty:A Clinical Study of 82 Cleft Palate Patients

Abstract

82 patients treated by velopharyngoplasty and speech therapy have been investigated by a foniatrician. The procedure of the speech evaluation and the speech therapy is described. No less than 76% demonstrated, at a general assessment, acceptable speech on follow-ups 1-10 years after the operation. Different speech qualities were also rated. Most relevant among the speech qualities is the open nasality, and 78% showed no or slight open nasality after operation. All patients but two stated that their speech had been improved by the operation; the 2 patients noticed no difference. Two types of pharyngeal flaps operation had been used: the flap based superiorly or inferiorly. The same good result was proved for both types of operation, and the general assessment and rating into different speech qualities showed remarkably good accord. The results were definitely better when the operation had been performed at an early age. There was no relation between speech results and the mobility of the palate or the muscular activity of the pharyngeal walls. The function of the velopharyngeal closure is discussed, and the importance of a velopharyngeal closure at a high level is emphasized. An operation at a low age is recommended though it is difficult to evaluate speech at this age. The principles for speech therapy are discussed.