Management of velopharyngeal competence.

Velopharyngeal dysfunction is common in patients with a repaired cleft palate or unrepaired submucous cleft palates. The optimal time of surgical repair is 4 to 6 years of age after a thorough speech evaluation and speech therapy. Assessment of the velopharyngeal defect during speech allows the surgeon to customize the surgery to the patient. Patients require careful monitoring postoperatively for obstructive sleep apnea.