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Cleft Palate Speech Surgery

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When velopharyngeal dysfunction is suspected, speech is investigated by two main techniques. The first is by video fluoroscopy. This is an X-ray test showing the palate moving during speech. It is useful to assess the shape and movement of the palate and to give an idea of any gap in the “valve” mechanism that will require surgery to correct.

The other test is nasoendoscopy, in which a small camera is passed through a nostril until it is looking at the top of the soft palate during speech. During this test, the movements of the palate and back of the throat can be seen directly, and any gap in the “valve” mechanism can be seen.

Using the results from these two investigations, your surgeon will determine whether surgery is likely to help and which operation is likely to give the best result with the lowest risk of complications. At Children’s Health℠, we offer a large range of techniques for speech surgery and can provide a tailored approach to the individual.

The main problem that speech surgery is trying to correct is that the soft palate is not working well as a valve to block air flowing into the nose during speech. Normally the palate does this by moving upward and backward so that it seals against the back of the throat. When the soft palate isn’t able to make this seal, it can be because the soft palate itself isn’t moving correctly, that the soft palate is moving well but is too short or a combination of the two.

Types of surgery to correct this include:

  • An operation to relocate the muscles of the soft palate to allow it to move more effectively
  • An operation to lengthen the soft palate either by rearranging the shape of the palate or by using tissue from elsewhere in the mouth
  • An operation to narrow the space behind the soft palate so that the soft palate has a smaller gap to close
  • An operation to fix the soft palate to the back of the throat and to create a new valve system that can be controlled by the muscles of the throat

Your surgeon will discuss and explain the benefits and potential problems associated with each option and will suggest a plan to provide the best outcome.

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