An evaluation of velopharyngeal ring ligation in cleft palate repair.

PURPOSE: This article describes the details of the velopharyngeal ring ligation procedure (VPRL) and compares the results with those achieved with the von Langenbeck (VL) and pharyngeal flap procedures (PFP).

PATIENTS AND

METHODS

A random sample of 52 patients was evaluated postoperatively by phonation tests, measurement of oral pressure, pharyngeal fluoroscopy, and cineradiography.

RESULTS

The results showed that the speech of the VPRL group was significantly better than that of the VL group. The velopharyngeal competence rate, the anteroposterior nasopharyngeal minimal diameter, the left-right nasopharyngeal minimal diameter (both in repose and on phonation), and the length of the soft palate were significantly different between VPRL and VL, and between VPRL and PFP. Differences in the velar angle were significant between VPRL and PFP and between PFP and VL, but there was no significant difference between VPRL and VL.

CONCLUSIONS

VPRL is a better method for cleft palate repair than the VL or PFP procedures. It can reduce the nasopharyngeal space circumferentially, thus improving the patient's speech.