Abstract
Oro-facial clefts involving the palate is the commonest structural defect causing velopharyngeal insufficiency (VPI) and poor intelli gibility of speech. Proper repair of the soft palateis a surgical challenge. Posterior-based buccinator myomucosal flap (BMF) is used to lengthen the soft palate of patients who undergo primary palatoplasty at Teaching Hospital, Karapitiya (THK). BMF is a good choice for the repair of medium sized mucosal defects in the oral cavity since it has appropriate thickness, contains mucous membrane with mucous glands and has a rich blood supply. Objectives To assess improvement in quality of speech after soft palate repair using BMF in patients with previously corrected cleft pate. Thirty four patients (M:F-1:1) who had undergone palatal lengthening using BMF procedure for correction of VPI for speech improvement at Teaching Hospital, Karapitiya from 2010 to 2012, were assessed before and one year after surgery for quality of speech. All patients below 8 years showed significant reduction of hypernasality (p<0.05), whereas only 60% of patients above 8 years showed reduction after the surgery. All patients showed reduction in nasal air emission and in consonant production error at least by one consonant. The group below 8 years showed more improvement in speech quality after surgery. Palatal lengthening using BMF procedure is a good treatment option for correction of VPI.
Highlights
Oro-facial clefts involving the palate is the commonest structural defect causing velopharyngeal insufficiency (VPI) and poor intelli gibility of speech
Altered speech has a negative effect on socialinteractions and self-esteem at any stage of human life
Structural, functional, mechanical and phoneme specific abnormalities are the causes for VPI
Summary
Oro-facial clefts involving the palate is the commonest structural defect causing velopharyngeal insufficiency (VPI) and poor intelli gibility of speech. Posterior-based buccinator myomucosal flap (BMF) is used to lengthen the soft palate of patients who undergo primary palatoplasty at Teaching Hospital, Karapitiya (THK). Velopharyngeal insufficiency (VPI) results in hypernasality, nasal emission and poor speech quality, and nasal regurgitation during feeding [1,2]. The commonest structural defect causing VPI is the oro-facial clefts involving the palate. VPI is seen in about 20% to 30% of individuals who have undergone primary palatoplasty and in 5% to 10% of patients with a submucous cleft palate [1,2,3]
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