Abstract
BackgroundVelopharyngeal insufficiency that accompanies speech resonance and articulation disorders can be managed through several intervention methods such as speech-language therapy, prosthetic aids, and surgery. However, for patients with severe hypernasality, surgical interventions are highly recommended. Among available surgical techniques, the posterior pharyngeal flap is most common.Case presentationTwo adult males with high nasalance scores underwent superiorly based posterior pharyngeal flap surgery, followed by speech testing by an expert speech-language therapist. Nasalance scores and articulation accuracy were assessed up until 1 year after the surgery. Nasalance scores were measured five times using a nasometer, after which the average value was calculated.ConclusionsConsistent declines in hypernasality over time are not easy to explain since the pedicled pharyngeal flap narrowed over time, secondary to cicatrization. However, scar tethering of the soft palate in a posterior direction could reduce the velopharyngeal port size over time. Therefore, long-term follow-up with intensive speech therapy is suggested for patients with severe hypernasality.
Highlights
Velopharyngeal insufficiency that accompanies speech resonance and articulation disorders can be managed through several intervention methods such as speech-language therapy, prosthetic aids, and surgery
Long-term follow-up with intensive speech therapy is suggested for patients with severe hypernasality
Velopharyngeal insufficiency (VPI) involves inability to adequately close the velopharyngeal (VP) port, which consists of the soft palate, and posterior and lateral pharyngeal walls
Summary
Velopharyngeal insufficiency that accompanies speech resonance and articulation disorders can be managed through several intervention methods such as speech-language therapy, prosthetic aids, and surgery. Case presentation: Two adult males with high nasalance scores underwent superiorly based posterior pharyngeal flap surgery, followed by speech testing by an expert speech-language therapist. Velopharyngeal insufficiency (VPI) involves inability to adequately close the velopharyngeal (VP) port, which consists of the soft palate, and posterior and lateral pharyngeal walls. Due multiple VPI-related problems such as feeding and swallowing difficulties, speech disorders, and chronic ear infections, most surgeons recommend reparative surgery before the age of 12~18 months for patients with cleft palates. Speech disorders that frequently persist following repair surgery include articulation and resonance. The management of VPI-related speech disorders frequently involves speech-language therapy, prosthetics, surgical interventions, or a combination of several methods. High rates of around 80–90% improvement in VP function have
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