Posterior pillar webbing and palatopharyngeus displacement: possible causes of congenital palatal incompetence.

Three cases of congenital palatal incompetence in the absence of the usual stigmata associated with hypernasality are presented. In two instances, mucosal webbing of the posterior pillars was noted and in one case the palatopharyngeus muscle was displaced. Hypernasal voice quality was apparent in each patient. A z-plasty on both sides of the posterior pillars is suggested as the treatment of choice when no other morphologic abnormalities are present.