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International Journal of Otolaryngology
Volume 2012 (2012), Article ID 296073, 3 pages
http://dx.doi.org/10.1155/2012/296073
Clinical Study

Noncleft Velopharyngeal Insufficiency: Etiology and Need For Surgical Treatment

1Department of Otolaryngology, Vanderbilt University, Nashville, TN, USA
2Department of Radiology, University of Washington, Seattle, WA, USA
3Department of Otolaryngology Head and Neck Surgery, University of Iowa, Iowa City, IA, USA

Received 28 November 2011; Accepted 23 January 2012

Academic Editor: James Brookes

Copyright © 2012 Steven Goudy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Velopharyngeal insufficiency (VPI) occurs frequently in cleft palate patients. VPI also occurs in patients without cleft palate, but little is known about this patient population and this presents a diagnostic dilemma. Our goal is to review the etiology of noncleft VPI and the surgical treatment involved. Design/Patients. A retrospective review of VPI patients from 1990 to 2005. Demographic, genetic, speech, and surgical data were collected. We compared the need for surgery and outcomes data between noncleft and cleft VPI patients using a Student’s 𝑡 -test. Results. We identified 43 patients with noncleft VPI, of which 24 were females and 19 were males. The average age at presentation of noncleft VPI was 9.6 years (range 4.5–21). The average patient age at the time of study was 13.4 years. The etiology of VPI in these noncleft patients was neurologic dysfunction 44%, syndrome-associated 35%, postadenotonsillectomy 7%, and multiple causes 14%. The need for surgical intervention in the noncleft VPI group was 37% (15/43) compared to the cleft palate controls, which was 27% (12/43). There was not a statistical difference between these two groups ( 𝑃 > 0 . 5 ). Conclusion. Noncleft VPI often occurs in patients who have underlying neurologic disorders or have syndromes. The rate of speech surgery to address VPI is similar to that of cleft palate patients. We propose that newly diagnosed noncleft VPI patients should undergo a thorough neurologic and genetic evaluation prior to surgery.