We report the assessment of velopharyngeal closure (VPC) in children with cleft palates. VPC was evaluated by the following four methods: assessment of vocal resonance of vowel production and conversation, articulation of a plosive consonant /p/, hard blowing and soft blowing. In addition, laterall view radiography and nasopharyngeal fiberscopy were used on patients with velopharyngeal incompetence. The age of palatoplasty in our 120 cleft palate patients was 12 months in 58 cases, 13 months in 40 cases and 14 months in 22 cases. The operation method was palatal pushback.
The results were as follows:
1) VPC was good in 107 cases (89.1%), fair in 10 (8.3%), poor in 3 (2.6%) .
2) Nearly all of the patients could be evaluated by our four methods at 3-and-a-half years old.
3) Lateral view radiography could be carried out for cases older than 3 years and nasopharyngeal fiberscopy for those older than 6 years.
4) VPC was diagnosed in about 68% of the patients under 4 years old, but 17% of the patients were not diagnosed until 5 years.
5) Delayed diagnosis of VPC related significantly to the severity of VPC, palatal fistulae and articulation disorders.
6) Some patients who had good VPC showed mild hypernasality and a mild degree of nasal escape in the blowing test until 3-and-a-half years old.
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