PURPOSE:
to investigate the effect of surgical management of velopharyngeal insufficiency on the speech resonance in individuals with cleft palate that presented hypernasality after orthognathic surgery.
METHODS:
twenty-three cleft palate subjects that underwent surgical management of velopharyngeal insufficiency were analyzed. All patients presented normal speech resonance before orthognathic surgery and underwent surgical management of velopharyngeal insufficiency due to hypernasality observed after orthognathic surgery. Patients were submitted to perceptual speech evaluation for classification of nasality in three situations: 3 days before and five months, on average, after orthognathic surgery and 13 months, on average, after surgical management of velopharyngeal insufficiency. Hypernasality was classified using a 4-point scale: 1=absence of hypernasality; 2=mild hypernasality; 3=moderate, and 4=severe. Hypernasality scores in the three situations studied were compared by Friedman test, with a significance level of 5% and then by Tukey test for multiple comparisons.
RESULTS:
from the total of 23 patients, elimination of the speech symptom after surgical management of velopharyngeal insufficiency was observed in 83% (19/23) of the cases. The mean scores of nasality before orthognathic surgery=1, after orthognathic surgery=3 and after surgical management of velopharyngeal insufficiency=1. There was a significant difference among the three clinical situations studied (p<0.001).
CONCLUSION:
surgical management of velopharyngeal insufficiency was an effective treatment in most cases of velopharyngeal insufficiency following to orthognathic surgery, reestablishing normal speech condition.
Cleft Palate; Velopharyngeal Insufficiency; Orthognathic Surgery
