Velopharyngeal in-competence(VPI) is a common abnormality seen in Cleft
palate patients causing hyper nasal speech which is a major communicative disorder
in such patients. Assessment of this VPI is complex process due the
Velopharyngeal apparatus being a combination of soft palate structures that regulate
the airflow from the lungs and larynx through the mouth for oral sounds through the
nose for nasal sounds.
The present study of perceptual speech and flexible video endoscopy in
patients with cleft palate pathology indicates a co-relation between speech defect
and type of VPI. In management of patients with cleft palate, it is important that
surgical correction of the defect is done at the same time achieving velopharyngeal
competency for speech without creating nasal airway obstruction. Velopharyngeal
endoscopy with speech assessment will define the anatomic and functional bases for
the velopharyngeal correction and also to plan /tailor pharyngeal flaps. This
approach also appears to be a useful and necessary tool for ‘surgical feedback’.
Hence a multidisciplinary approach involving Otolaryngologists / Plastic surgeons /
Speech pathologists for preoperative evaluation of the defect with perceptual speech
analysis and velopharyngeal endoscopy is mandatory
