Surgical correction of velopharyngeal insufficiency with and without compensatory articulation.

The final speech outcome in cleft palate patients depends on two elements: normalization of nasal resonance and correction of compensatory articulation (CA). The purpose of this paper is to demonstrate whether early surgical correction of velopharyngeal insufficiency (VPI) may decrease total time of speech therapy (ST) necessary to completely eliminate CA. A group of 29 cleft palate patients in which VPI and CA were demonstrated, were selected for the study group. Fourteen patients were randomly selected and underwent surgical correction of VPI as soon as placement of articulation during isolated speech was normal. The other 15 patients underwent speech therapy aimed to correct CA, these patients were followed until articulation was normal during connected speech. At this point in time they underwent surgical correction of VPI as the other 14 patients. Success rate for correcting VPI after the operation was not significantly different for both groups. Furthermore, total time of ST was not significantly different for both groups. It is concluded that normalization of nasal resonance before articulation is corrected during connected speech does not seem to reduce total time of ST necessary to completely correct CA in cleft palate patients.