Velopharyngeal Insufficiency Induced by a Postoperative Palatal Fistula during Articulation Development Period: A Case Report.

Baek, Rong Min; Park, Mi Kyong; Lee, Sang Woo

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(2):175-177.
Published online March 1, 2010.

Velopharyngeal Insufficiency Induced by a Postoperative Palatal Fistula during Articulation Development Period: A Case Report.

Rong Min Baek, Mi Kyong Park, Sang Woo Lee

Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Korea. sangwoolee7@naver.com

Abstract

PURPOSE
Velopharyngeal insufficiency(VPI) during articulation development period can cause compensatory articulation like glottal stop, which can maintain VPI symptoms such as hypernasality and nasal emission despite of recovered velopharyngeal function. METHODS: A girl visited our department with speech problems such as hypernasality, compensatory articulation patterns, and nasal air emission. She had history of post-palatoplasty fistula which was repaired after 1 year follow-up.
RESULTS
After treated with speech therapy without surgery, her hypernasal speech problem was corrected. From this, we could assume that the fistula during articulation development period induced VPI, which leads to glottal substitution and this compensatory articulation maintained VPI though the fistula was repaired.
CONCLUSION
In this report, we could observe that palatal fistula in articulation development period can have detrimental effect on articulation, and also we could confirm that evaluation of soft palate mechanism with using speech sample without compensatory articulations prevent the patient from unnecessary operation.

Keywords: Velopharyngeal insufficiency; Compensatory articulation; Palatal fistula; Articulation developmental period