Is there an optimal resting velopharyngeal gap in operated cleft palate patients?

CONTEXT: Videofluoroscopy in operated cleft palate patients.

AIMS: To determine the existence of an optimal resting velopharyngeal (VP) gap in operated cleft palate patients.

SETTINGS AND DESIGN: A retrospective analysis of lateral view videofluoroscopy of operated cleft palate patients.

MATERIALS AND METHODS: A total of 117 cases of operated cleft palate underwent videofluoroscopy between 2006 and 2011. The lateral view of videofluoroscopy was utilised in the study. A retrospective analysis of the lateral view of videofluoroscopy of these 117 patients was performed to analyse the resting VP gap and its relationship to VP closure.

STATISTICAL ANALYSIS USED: None.

RESULTS: Of the 117 cases, 35 had a resting gap of less than 6 mm, 34 had a resting gap between 6 and 10 mm and 48 patients had a resting gap of more than 10 mm.

CONCLUSIONS: The conclusive finding was that almost all the patients with a resting gap of <6 mm (group C) achieved radiological closure of the velopharynx with speech; thus, they had the least chance of VP insufficiency (VPI). Those patients with a resting gap of >10 mm (group A) did not achieve VP closure on phonation, thus having full-blown VPI. Therefore, it can be concluded that the ideal resting VP gap is approximately 6 mm so as to get the maximal chance of VP closure and thus prevent VPI.