Evaluation of velopharyngeal morphology and surgical recovery in cleft palate patients with different types of velopharyngeal functions.

Background: To investigate key factors related to the velopharyngeal insufficiency (VPI) by evaluating velopharyngeal morphology, soft palate mobility and surgical recovery in cleft palate patients with different types of velopharyngeal function.

Methods: CT data was used to compare morphology in 49 postoperative velopharyngeal competence (VPC), 39 VPI, and 49 non-cleft individuals. Ultrasound assessed surgical recovery in 87 VPC, 77 VPI, and 75 non-cleft individuals. Soft palate mobility was evaluated in 20 VPC and 17 VPI patients through cephalometric X-rays.

Results: In terms of velopharyngeal morphology, both VPC and VPI groups exhibited shorter velar and hard palate ratios, longer pharyngeal ratio, and lower VP ratio compared to the non-cleft group (p < 0.05), but there were no significant differences between VPC and VPI (p > 0.05). Both groups exhibited significantly lower echo intensity (EI), higher intensity dispersion index (IDI) and lower logarithm unit color velocity (LUCV) values compared to the non-cleft group (p < 0.05). However, the differences in EI, IDI and LUCV between the VPC and VPI groups were not statistically significant (p > 0.05). In contrast, VPC group showed significantly better soft palate mobility compared to VPI, with greater elevation angle (p = 0.042) and higher closure rate (p = 0.001) during speech.

Conclusion: The VPC group showed significantly improved soft palate mobility compared to the VPI group; however it was interesting to note the lack of significant differences in velopharyngeal morphology and surgical recovery in postoperative cleft palate patients with VPC and VPI.