Treatment and Result of Slight Velopharyngeal Incompetence.

Abstract

Fifty-five patients who had been diagnosed as slight velopharyngeal incompetence due to either repaired cleft palate CP (19 cases), submucous cleft palate SMCP (21) or congenital velopharyngeal incompetence CVPI (15) at our clinic from May 1976 to April 1982 were studied regarding the effect of speech therapy. They were all first placed under trial speech therapy which consisted of ① encouragement of the physical and mental development, ② articulation training without blowing exercise. Twenty-seven out of the 55 subjects underwent further surgery (mostly pharyngeal flap operation) after speech therapy for over 6 months at our clinic. On the other hand, 14 out of the 55 subjects improved velopharyngeal closure from slight incompetence to competence and corrected their faulty articulations through speech therapy alone. The success rate of speech therapy was higher in SMCP and CVPI than in repaired cleft palate. We emphasize that those who are judged as having slight velopharyngeal incompetence should first be placed under speech therapy for at least 6 months. The indication for further surgery are ① over age 5 years, and ② no improvement obtained in slight velopharyngeal incompetence and faulty articulation even by speech therapy for over one year.