Velopharyngeal function for speech after the Frolova primary palatoplasty technique.

Objective: This study was undertaken by several members of the University of Florida Craniofacial Center to assess the results of palatoplasty performed by the method devised by Larisa Y. Frolova, M.D.

A methodology report of a randomized prospective clinical trial to assess velopharyngeal function for speech following palatal surgery.

Cleft lip and palate occurs in approximately 1 in every 750 live human births, making it one of the most common congenital malformations. Surgical closure of the palatal cleft does not always result in a velopharyngeal port capable of supporting normal speech. The University of Florida (UF), in collaboration with the University of São Paulo (USP), is engaging in a 5-year prospective, randomized controlled study to compare velopharyngeal function for speech outcomes between patients undergoing palatoplasty for complete unilateral cleft lip and palate performed using the von Langenbeck procedure with intravelar velarplasty and those receiving the Furlow double-reversing Z-plasty palatoplasty.

Methods of assessing speech in relation to velopharyngeal function.

Seven speech pathologists with expertise in the evaluation of the speech of individuals with cleft palate agreed that the following parameters should be assessed: case history, oral-peripheral mechanism, articulation, and voice quality. From such information and observations the clinician should be in a position to make inferences about velopharyngeal function. If velopharyngeal function is not normal, it is mandatory that additional information about the mechanism be obtained.

A long term study on treating velopharyngeal insufficiency by teflon injection.

Thirty-five individuals with velopharyngeal insufficiency, including eight with failed pharyngeal flaps, were treated with injectable Teflon and followed postoperatively for an average of three years. The patients' speech and voice quality were evaluated pre- and postoperatively, and an outcome was judged successful only if there was total elimination of the preoperative symptoms of hypernasality and inappropriate nasal air emission. All patients were evaluated preoperatively with cinefluorography, and an attempt was made to obtain serial postoperative films in order to determine the stability of the Teflon pad with time.

Evaluation of speech after correction of rhinophonia with pushback palatoplasty combined with pharyngeal flap.

A comparison is made of the preoperative and postoperative speech evaluations of 15 selected subjects who had pharyngeal flap operations combined with palatal pushback. Postoperatively, 13 of the 15 patients (86 percent) showed no abnormal nasal emission and no evidence of significant hypernasality during word production. Gross substitution errors were also corrected by the surgical repair.