Evaluation of Velopharyngeal Morphology and Surgical Recovery in Cleft Palate Patients with Different Types of Velopharyngeal Function.

Abstract

The purpose of this study was to investigate key factors related to velopharyngeal insufficiency (VPI) by evaluating velopharyngeal morphology, soft palate mobility, and surgical recovery in cleft palate patients with different types of velopharyngeal function. Computed tomographic data were used to compare morphology in 49 postoperative velopharyngeal competence (VPC), 39 VPI, and 49 noncleft individuals. Ultrasound was used to assess surgical recovery in 87 VPC, 77 VPI, and 75 noncleft individuals. Soft palate mobility was evaluated in 20 VPC and 17 VPI patients through cephalometric radiographs. In terms of velopharyngeal morphology, both VPC and VPI groups exhibited shorter velar and hard palate ratios, longer pharyngeal ratio, and lower velopharyngeal ratio compared with the noncleft group ( P < 0.05), but there were no significant differences between VPC and VPI ( P > 0.05). Both groups exhibited significantly lower echo intensity, higher intensity dispersion index, and lower logarithm unit color velocity values compared with the noncleft group ( P < 0.05). However, the differences in echo intensity, intensity dispersion index, and logarithm unit color velocity between the VPC and VPI groups were not statistically significant ( P > 0.05). In contrast, the VPC group showed significantly better soft palate mobility compared with VPI, with greater elevation angle ( P = 0.042) and higher closure rate ( P = 0.001) during speech. The VPC group showed significantly improved soft palate mobility compared with the VPI group; however, it was interesting to note the lack of significant differences in velopharyngeal morphology and surgical recovery in postoperative cleft palate patients with VPC and VPI.