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Pharyngoplasty and VPI

Ann Kummer, Ph.D,CCC-SLP

June 29, 2009

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Question

I'm treating a little boy who has had a pharyngoplasty to repair a submucous cleft (surgery was 7/08). He does not appear to have VP closure; his nasoendoscopy is not until February, 2009. In conjunction, he's apraxic as well! Aside from his obvious re

Answer

A pharyngoplasty does not guarantee that velopharyngeal closure is adequate. The nasoendoscopy will be important because a flap revision may be necessary. If he still has VPI, despite the flap, and this is corrected with a flap revision, this will help to improve overall speech potential.

Regardless of the results of the nasoendoscopy or velopharyngeal function, the only thing that you can work on is articulation. I would continue to try to improve articulation placement using cueing techniques that are effective with apraxia. By the way, blowing and sucking exercises are NEVER appropriate for this type of problem.

Dr. Kummer is Senior Director of the Speech Pathology Department at Cincinnati Children's and Professor of Clinical Pediatrics at the University of Cincinnati Medical Center. She is the current Coordinator of ASHA's Division 5: Speech Science and Orofacial Anomalies and is an active member of the American Cleft Palate-Craniofacial Association. She does many lectures and seminars on a national and international level. She is the author of many professional articles and 11 book chapters. She is also the author of the text entitled Cleft Palate and Craniofacial Anomalies: The Effects on Speech and Resonance, 2nd Edition, Clifton Park, NY: Delmar Cengage Learning, 2008. She is an ASHA Fellow.


Ann Kummer, Ph.D,CCC-SLP


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