Velar Motility, Velopharyngeal Closure, and Speech Proficiency in Cartilage Pharyngoplasty: The Effect of Age at Surgery

Abstract

This report is the second in a series of articles describing a program of research concerning the effectiveness of cartilage pharyngoplasty. In the first article (2) the research design was described and results regarding relative improvement in velar motility, velopharyngeal closure, and certain speech parameters, were reported on a longitudinal basis. There was a general impression from the findings reported in the earlier report (2) that subjects who were operated on at an early age tended to exhibit greater benefits from the operation in terms of velopharyngeal closure than those who were older at the time of the operation. Moreover, they appeared to surpass the older subjects in the degree to which they could effect velopharyngeal valving prior to the operation. Without the benefit of statistical analysis, it appeared generally that the intervention of cartilage pharyngoplasty during or before the most dramatic downward, forward emergence of the maxillo-facial complex from the cranial base (presumably by growth) resulted in relatively better velopharyngeal restoration. In addition, the speech findings indicated that the subjects of younger operative age showed reduced nasality, better articulatory proficiency, and better intelligibil— ity when compared to the subjects who had surgery at older ages. Therefore, the purpose of the present report is to describe in some detail the preoperative and postoperative characteristics of two age groups of subjects with regard to degree of velar motility, degree of velopharyngeal closure, and degree of speech proficiency (nasal reso— nance, articulatory proficiency, and intelligibility). Procedures The details of the overall procedures and methods of analysis were outlined in a previous report (2) and are reviewed here only briefly.