Purpose
to investigate the long-term effect of intravelar veloplasty for surgical management of velopharyngeal insufficiency (VPI) on hypernasality of individuals with repaired cleft palate.
Methods
sixty patients with repaired cleft palate±lip and residual VPI, of both genders, aged 4 to 52 years were analyzed. The patients underwent secondary palatoplasty with intravelar veloplasty. A perceptual speech assessment was used to rate hypernasality using a 6 point-scale, where 1=absent and 6=severe hypernasality. Nasometry was performed for determining nasalance, the acoustic correlate of nasality, during the reading of a set of five Brazilian Portuguese sentences containing only oral sounds, using a cutoff score of 27%. The assessments were done 4 days before and 16 months after surgery, on average, and the surgical success was analyzed based on reduction and elimination/normalization of hypernasality and nasalance.
Results
postoperative decreases of hypernasality and nasalance scores were observed in 75% and 52% of the patients, respectively. Lower percentages were observed when the criterion of analysis was elimination/normalization (32% of hypernasality elimination and 38% of nasalance normalization, respectively).
Conclusion
intravelar veloplasty was shown to be an effective procedure in reducing the most important symptom of VPI in the long-term, and should be seen at as a first approach for VPI management.
Cleft Palate; Velopharyngeal Insufficiency; Palate; Speech; Surgical Procedures; Operative
