Abstract
The speech prognosis of 28 patients 2 to 3 years after pharyngeal flap surgery performed at the National Center for Child Health and Development was evaluated. Velopharyngeal function was graded by 4 levels, and articulation errors related to velopharyngeal function were evaluated by 3 speech therapists at our Center. The operation was performed at the median age of 6 years (range: 3 to 14) . Speech therapy was performed in all the cases post-operatively. Ten patients were post-operative state of cleft palate, 9 were submucous cleft palate and 9 were congenital velopharyngeal insufficiency. Velopharyngeal function of all the patients was graded in the lower 2 levels before surgery. After pharyngeal flap surgery, velopharyngeal function was improved in all cases, and approximately 90% of patients were graded into the higher 2 levels, at which patients are thought to experience no problems in daily linguistic communication. Articulation errors were present in 12 cases pre-operatively, and decreased to 7 cases post-operatively. 22q11.2 deletion syndrome was present in 5 cases, and their velopharyngeal function was graded into relatively lower levels at 2 to 3 years post-operatively, but gradually improved at 4 years post-operatively. Mental retardation (IQ ≤ 70) was present in 9 cases, and their velopharyngeal function was graded into significantly lower levels compared to those without mental retardation at 2 to 3 years post-operatively. Pharyngeal flap surgery and speech therapy were effective treatments to improve velopharyngeal function and related articulation errors. Patients with 22q11.2 deletion syndrome require a longer period of speech therapy for improvement. A smaller level of improvement is expected in patients with mental retardation, probably due to difficulty in learning appropriate speech function.
