Long-Term Management of Velopharyngeal Insufficiency and Misarticulation in Unilateral Cleft Lip and Palate: Speech Therapy Outcomes.

This report highlights the long-term management of velopharyngeal insufficiency (VPI) and misarticulation in an 18-year-old male with unilateral cleft lip and palate. Despite primary and secondary surgeries, persistent VPI required a speech appliance and intensive therapy to address glottal stops and pharyngeal fricatives. While therapy eliminated these errors, residual VPI continued to impact speech intelligibility. Reassessment revealed that while some misarticulations persisted, the patient retained speech improvements from prior therapy, allowing for partial substitutions of target sounds. This case emphasizes the role of speech therapy in managing misarticulation despite unresolved VPI and highlights the need for ongoing multidisciplinary care.