الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
A treatment plan is developed and may include speech therapy, use of a prosthetic device, and/or surgical intervention. Different surgical options are discussed, including posterior pharyngeal flap, sphincter pharyngoplasty, Furlow palatoplasty, palatal re-repair, and posterior pharyngeal wall augmentation.
An estimated 30% to 50% of children will have VPI after initial palate repair. Another cause of nasal air escape is palatal fistula. VPI is diagnosed by listening to a child’s speech. Videofluoroscopy or nasendoscopy may further confirm the diagnosis and define the anatomic problem.In videofluoroscopy, multiple x-ray films are take while the patient speaks, whereas nasendoscopy allows direct visualization of the soft palate and lateral and posterior pharyngeal wall movement during speaking.
The treatment for VPI is speech therapy. Surgery is necessary in 20% of children to achieve intelligible speech. This surgery involves extending the soft palate by creating a pharyngeal flap, or decreasing the velopharyngeal port size by pharyngoplasty .
Cleft type, operative age and surgical technique were the contributing factors influencing VPC rate after primary palatal repair of cleft palate patients.
In summary an earlier palatal closure might be desirable from speech and psychological aspects, but is suspected to lead to a higher rate of early and late complications.