• 대한구순구개열학회지
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• 제15권1호
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• pp.39-50
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• 2012

A submucous cleft palate(SMCP) is characterized by a midline deficiency or lack with/without incorrect positioning of muscular tissues in the soft palate, and by a bony defect in the midline or the center of the hard palate. Velopharyngeal incompetence(VPI) related to this SMCP has been managed by various surgical and prosthetic techniques. Because the individual diagnosis and treatment of SMCP patients was not easy to the speech pathologist and to the maxillofacial reconstructive surgeons, and for the better understanding and for the ideal approaches to the SMCP patients, we reviewed several recent articles about grading system in the SMCP caused by VPI, and summarized in this review article.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.19.1-19.6
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• 2019

Background: The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy. Case presentation: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal. Conclusions: Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.