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BioMed Research International
Volume 2015 (2015), Article ID 196240, 11 pages
http://dx.doi.org/10.1155/2015/196240
Review Article

Current Controversies in Diagnosis and Management of Cleft Palate and Velopharyngeal Insufficiency

1Speech and Language Pathology Services, Ian Jackson Craniofacial and Cleft Palate Clinic-Neuroscience Program, Beaumont Health System, 3535 West 13 Mile Road, Royal Oak, MI 48073, USA
2Center for Genetics and Genomics, Facultad de Medicina, Clinica Alemana, Universidad del Desarrollo, Avenida Las Condes 12438, 7710162 Santiago, Chile
3Hospital Padre Hurtado, Avenida Esperanza 2150, San Ramon, 8880465 Santiago, Chile
4Cleft Palate Clinic, Hospital Gea Gonzalez, Calzada Tlalpan 4800, 14000 Mexico City, DF, Mexico
5Ian Jackson Craniofacial and Cleft Palate Clinic, Neuroscience Program, Beaumont Health System, 3535 West 13 Mile Road, Royal Oak, MI 48073, USA

Received 26 December 2014; Revised 16 February 2015; Accepted 2 March 2015

Academic Editor: Juan A. Sanchis-Gimeno

Copyright © 2015 Pablo Antonio Ysunza 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

Background. One of the most controversial topics concerning cleft palate is the diagnosis and treatment of velopharyngeal insufficiency (VPI). Objective. This paper reviews current genetic aspects of cleft palate, imaging diagnosis of VPI, the planning of operations for restoring velopharyngeal function during speech, and strategies for speech pathology treatment of articulation disorders in patients with cleft palate. Materials and Methods. An updated review of the scientific literature concerning genetic aspects of cleft palate was carried out. Current strategies for assessing and treating articulation disorders associated with cleft palate were analyzed. Imaging procedures for assessing velopharyngeal closure during speech were reviewed, including a recent method for performing intraoperative videonasopharyngoscopy. Results. Conclusions from the analysis of genetic aspects of syndromic and nonsyndromic cleft palate and their use in its diagnosis and management are presented. Strategies for classifying and treating articulation disorders in patients with cleft palate are presented. Preliminary results of the use of multiplanar videofluoroscopy as an outpatient procedure and intraoperative endoscopy for the planning of operations which aimed to correct VPI are presented. Conclusion. This paper presents current aspects of the diagnosis and management of patients with cleft palate and VPI including 3 main aspects: genetics and genomics, speech pathology and imaging diagnosis, and surgical management.