Prognostic Factors Influencing Speech Outcomes Following Secondary Palatal Surgery with Intravelar Veloplasty (IVVP) in Individuals with Velopharyngeal Insufficiency

Abstract

ObjectiveThe study examined how various prognostic factors-such as severity of hypernasality, patient's age, nasalance score, type of cleft, and the surgeon performing the procedure-affected the degree of hypernasality assessed after Intravelar veloplasty (IVVP) surgery.DesignRetrospective cohort study.SettingThe study was conducted at the Isfahan Cleft Care Team (ICCT), a university-affiliated tertiary care center.Patients/ParticipantsNinety-three nonsyndromic patients with velopharyngeal insufficiency (VPI) secondary to cleft palate who underwent secondary palatal surgery using the IVVP technique between 2006 and 2023.InterventionIVVP secondary surgery.Main Outcome MeasureHypernasality was perceptually assessed at least 6 months following surgery using the CAPS-A protocol and its included rating scale.ResultsNormal resonance was observed after IVVP surgery in 25.8 of patients. The results of the logistic regression analysis showed that younger age at the time of secondary surgery (P = 0.021), lower nasalance score before secondary surgery (P < 0.001), moderate hypernasality before the secondary surgery (P < 0.001), and cleft type (bilateral cleft lip and palate) were predictive of IVVP success.ConclusionBased on the predictive factors identified in this study, the success of IVVP, as well as the likelihood of requiring additional secondary surgeries in individuals with VPI, can be anticipated.