OBJECTIVETo establish the optimized surgical procedure in our approach to treat the velopharyngeal insufficiency and improve the articulations of the patients with cleft palate over six years old.

METHODSThirty-seven subjects over six years (including six years) old underwent the palatoplasty and sphincter pharyngoplasty simultaneously. We assessed the outcome of the surgery by perceptual speech assessment, nasopharyngoscopy and lateral cephalogram 10 to 15 months postoperatively.

RESULTSTwenty-two subjects got complete velopharyngeal closure. The velopharyngeal closure ratio of 15 subjects were over 85% according to the findings of the nasopharyngoscopy. Lateral cephalograms reveal that all the subjects could get their velars raised and well contacted with the posterior pharyngeal wall in dynamic condition. Perceptual speech assessment: The rate of hypernasality and nasal emission decreased significantly, and the consonant articulation increased.

CONCLUSIONOur surgical procedure in this study corrected the velopharyngeal insufficiency and improved the articulation of the patients over six years old significantly.