Rhinomanometry evidence in children treated by Furlow’s palatoplasty for velopharyngeal insufficiency correlated to cleft palate

Background: Speech surgery outcomes for velopharyngeal insufficiency (VPI) are difficult to quantify. We investigated the correlation between objective measurements of nasal emission and speech assessment ratings in children undergoing Furlow palatoplasty for the treatment of cleft-related VPI. Methods: A total of 20 patients with VPI after primary cleft palate repair were recruited for Furlow's palatoplasty. All participants completed rhinomanometry (RM) and speech evaluation scored by two blinded speech-language pathologists. Pre- and postoperative results were compared using the paired t test. Statistical significance was set for P values < 0.05. Correlation tests were performed to identify the correspondence of the RM findings with the speech assessment ratings. Results: RM quantified a reduction of the expiratory flow postoperatively. The sensitivity for the RM was 1.00 and the specificity 0.95. The mean of the pre- versus postoperative values was 0.52 +/- 0.43 (range: 0.14-1.69) versus 0.51 +/- 0.54 (range: 0.18-1.8), P < 0.05. These values confirmed a reduction of the nasal emission postoperatively, which was consistent with the speech assessment reports. Conclusions: Combined subjective and objective measurements can complete the clinical assessment of these patients. RM measurements confirmed the velopharyngeal changes achieved with speech surgery.