Speech and nasendoscopic evaluation of velopharyngeal incompetence (VPI) in cleft palate patients.

Cleft lip and palate patients exhibit several problems prior to and following surgical repair of their deformities. Hypernasality and speech defects remain one of the outstanding problems. 82 cleft palate patients were subjected to a systematised speech evaluation and an examination of the velopharyngeal mechanism. Nineteen patients did not have any surgery of the palate whilst the remaining 63 had at least one surgical procedure to the palate. 54 had a Veau-Wardill-Kilner (V-W-K) procedure and the remaining had either a second palatal repair or a superiorly based pharyngoplasty. Good correlation of speech assessment to nasendoscopic evaluation was found. An improvement in the speech and nasendoscopic coding was found in patients who had surgical intervention to the palate. A nasendoscopic examination, ideally performed by the surgeon and a speech therapist, is a useful adjunct to speech evaluation.