Velopharyngeal function from the age of three to eight years in cleft palate patients

The purpose of this investigation was to study changes of velopharyngeal fu nction between the ages of 3 and 8 years. The subjects were 65 (30 girls an d 35 boys) Finnish-speaking non-syndromic children with isolated cleft pala te (CP, n = 35) and with unilateral cleft lip and palate (UCLP, n = 30) ope rated primarily at the age of 1.0-2.0 years. Before the age of 8 years, 16 children required velopharyngoplasty (VPP, ad modum Hoenig). The children w ere followed up for speech at the age of 3, 6 and 8 years. The perceptual s peech characteristics nasal air emission, hypernasality, weakness of pressu re consonants and compensatory articulations were registered. Indications f or a velopharyngeal flap (by VPP) were identified on the basis of perceptua l speech characteristics and confirmed by instrumental examinations. The re sults indicated that the method and timing of primary palatoplasty and sex did not correlate with the quality of velopharyngeal function. It was good both in children treated conservatively or with VPP at the age of 8 years. The children with a flap required speech therapy significantly more often t han other children. No child with VPP and only 12% of the children without VPP had simultaneous nasal air emissions and hypernasality. Compensatory ar ticulation was completely eliminated and weakness of pressure consonants wa s diagnosed only in 1 child without VPP. The CP children required significa ntly more often a velopharyngeal flap than the UCLP children. In conclusion , the CP and UCLP children develop a similar velopharyngeal function but in a different way. Copyright (C) 2001 S. Karger AG, Basel.