Alterations in velopharyngeal function after maxillary advancement in cleft palate patients.

Velopharyngeal function was assessed aerodynamically prior to surgery and at least 1 year following surgery in 24 cleft palate patients who underwent maxillary advancement. In 5 patients (23%) deterioration and in 5 patients (23%) improvement of velopharyngeal function was observed. In those patients whose velopharyngeal function improved, a pharyngeal flap was in place at surgery. Of the 5 patients whose velopharyngeal function deteriorated, 4 had adequate and 1 borderline adequate velopharyngeal function prior to surgery. In the remaining 14 patients, velopharyngeal function was unchanged. No relationship between the amount of maxillary advancement or the "need ratio" and velopharyngeal function was observed.