Speech results after Millard island flap repair in cleft palate and other velopharyngeal insufficiencies.

Twenty-four patients were evaluated for voice quality after primary palatal repair by the Millard island flap procedure. In patients with overt cleft palate, acceptable speech was obtained in 71 percent. In patients with velopharyngeal insufficiency without an overt cleft, the success rate was 60 percent. Although we consider this method reliable and useful, we have no reason to believe that it offers substantial advantages over other established procedures. We suggest that the main reason for our failures to achieve velopharyngeal competence and acceptable voice quality after a repair is the inherent hypoplasia of palatal musculature.