Abstract
Treatment results in 31 patients with congenital velopharyngeal incompetence (CVPI) compared with 30postoperative cleft palate patients showing velopharyngeal incompetence were presented.
The results are as follows.
1. Treatment results in CVPI patients were poorer than that in cleft palate patients. Ten percent of CVPI patients showed velopharyngeal incompetence (VPI) and 26% of them showed hypernasality though the VPI was improved.
2. Unsatisfactory results were obtained and a long period was required to improve velopharyngeal function in subjects with the velo-facial syndrome.
3. Prosthodontic treatment using speech aid appliance was effective for CVPI patients for improving of velopharyngeal incornpetence(VPI). In 6 cases(19%) of CVPI patients and 3 cases(10%) of cleft palate patients, speech aid appliances were removed after acquiring adequate velopharyngeal closure wi t hout surgical treatment.
4. Excellent results from surgical treament were obtained in cases who acquired good velopharyngeal closure using speech aid appliance.
5. Five patients under 3 years old with CVPI and with slight VPI obtained good results by speech therapy.
6. Patients with the velo-facial syndrome and those classified as type II required longer periods than cleft palate to acquire adequate velopharyngeal function by the prosthodontic procedure. The improveme nt process in CVPI cases without velo-facial syndrome and those classified as type I was simil a r to that in cleft palate, though the improvement rate was a little lower.
7. From these results, it was considered that prosthodontic treatment or speech therapy, or combined therapy of both should be selected as a primary treatment for CVPI. Indication of surgical treatment should be decided according to the results of these treatments.
