Prosthesis in velopharyngeal insufficiency: effect on nasal resonance.

A review of case history records showed that 80 postoperative cleft palate cases with velopharyngeal incompetence and hypernasal voice quality had received speech therapy once or twice a week for unspecified periods of time but were unable to produce normal nasal resonance prior to the fitting of a nasopharyngeal prosthesis. After the fitting, 59 (74 percent) had normal nasal resonance during clinical assessment with an additional 10 showing reduced but residual hypernasality. It therefore is suggested that speech therapy may not be the treatment of choice in many cases of velopharyngeal inadequacy. Creation of what may be considered a relatively more normal speech mechanism by means of pharyngeal prosthesis seems to result in normal nasal resonance in a large majority of cases.