[Clinical and nasometric study of velopharyngeal function in two-stage palatoplasty]

Since 1976 children born with complete cleft lip and palate have been treated according to two stage cleft palate repair regime, soft palate at one year of age and hard palate between 3-12 years of age. The objective of this paper is to present the clinical and instrumental speech evaluation and the velopharyngeal function of 41 patients, mean age 8.2 years, 28 unilaterals and 13 bilateral clefts; 7 cases had palatal fistulae larger than 5 mm2. The results showed moderate-severe hypernasality in 20% of cases, persisting articulatory errors with backing in 43% of cases, glotal stops in 2%, the intelligibility was deficient in 7%. The evaluation of the oro-nasal resonance with Nasometry showed suspicious or VPI values in 14 and 20% of cases respectively. Nasendoscopy findings showed same degree of VPI in 35% of cases. Repalatoplasty or fistula closure was needed in 17% and pharyngeal flap in 12% of cases. The great incidence of articulatory errors have promoted us to discontinue this technique.