Levator muscle reconstruction: resulting velopharyngeal competence--a preliminary report

The purpose of this study was to evaluate a levator muscle reconstruction procedure on the basis of resulting velopharyngeal competence. Ages of the patients at time of surgery ranged from 5 months to 7 years. The patients were reevaluated postoperatively. If the patients were judged to have normal nasality and no nasal emission, the procedure was considered to have yielded a satisfactory result. If hypernasality and nasal emission resulted, the patients were examined utilizing nasoendoscopy and/or videofluoroscopy. If velopharyngeal incompetence was confirmed, the operative procedure was judged to be successful. Results showed that 60 percent success was achieved. The age range which yielded the best results (73 percent satisfactory) was 37 to 60 months. The data also revealed that the more severe the cleft, the less likely this operative procedure is to produce satisfactory results. The authors recommend continued evaluation of this procedure, preferably utilizing prospective studies.