Influence of treatment concept, velopharyngoplasty, gender and age on hypernasality in patients with cleft lip, alveolus and palate.

OBJECTIVES: The aim of this study was to analyse cleft patients for hypernasality following velopharyngoplasty.

PATIENTS AND METHODS: 95 subjects (43 females, 52 males) with cleft lip, alveolus and palate (4 - 25 years old) were analysed. Forty-three patients were treated according to the current protocol of the Cleft Palate/Craniofacial Malformations Centre of the Department of Cranio-Maxillofacial Surgery in Muenster ('MS+' group) and 52 patients were treated elsewhere according to different protocols. In 19 of the 95 patients a velopharyngoplasty had been performed. Hypernasality was judged perceptually and nasalance data was measured objectively using the NasalView system.

RESULTS: Patients of the 'MS+' group showed significantly better results concerning hypernasality and nasalance data. Assessment of hypernasality and nasalance measurement showed no significant differences between subjects following velopharyngoplasty and those who had not had this operation. Gender and age did not correlate with hypernasality either.

CONCLUSION: A functionally orientated treatment with early closure of lip and palate ensures optimal velopharyngeal function, optimal oro-nasal balance of resonance, low hypernasality and excellent nasalance data.