title: Improvement of quality of speech in patients with velo-pharyngeal insufficiency corrected using a buccinator myomucosal flap.
abstract: BACKGROUND
  Oro-facial clefts involving the palate is the commonest structural defect causing velopharyngeal insufficiency (VPI) and poor intelli gibility of speech. Proper repair of the soft palateis a surgical challenge. Posterior-based buccinator myomucosal flap (BMF) is used to lengthen the soft palate of patients who undergo primary palatoplasty at Teaching Hospital, Karapitiya (THK). BMF is a good choice for the repair of medium sized mucosal defects in the oral cavity since it has appropriate thickness, contains mucous membrane with mucous glands and has a rich blood supply. Objectives To assess improvement in quality of speech after soft palate repair using BMF in patients with previously corrected cleft pate.
  
  
  METHODS
  Thirty four patients (M:F-1:1) who had undergone palatal lengthening using BMF procedure for correction of VPI for speech improvement at Teaching Hospital, Karapitiya from 2010 to 2012, were assessed before and one year after surgery for quality of speech.
  
  
  RESULTS
  All patients below 8 years showed significant reduction of hypernasality (p<0.05), whereas only 60% of patients above 8 years showed reduction after the surgery. All patients showed reduction in nasal air emission and in consonant production error at least by one consonant. The group below 8 years showed more improvement in speech quality after surgery.
  
  
  CONCLUSIONS
  Palatal lengthening using BMF procedure is a good treatment option for correction of VPI.
authors.affiliation: Oral and Maxillofacial Surgery Unit, Teaching Hospital, Karapitiya,Sri Lanka. dkdias@sltnet.lk.
authors.forename: D K
authors.initials: DK
authors.lastname: Dias
authors.forename: P D
authors.initials: PD
authors.lastname: Fernando
authors.forename: R D
authors.initials: RD
authors.lastname: Dissanayake
mesh_terms: D002648:Child; D002972:Cleft Palate / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010160:Palate, Soft / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D013065:Speech Intelligibility / Q000502:physiology; D013068:Speech Production Measurement / Q000379:methods; D013524:Surgical Flaps; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery