ESTABLISHMENT of normal speech in velopharyngeal insufficiency is the goal of various procedures proposed by many authors.
Velopharyngeal insufficiency is not uncommon and is very disagreeable for the patient as well as for the surgeon who is confronted with the responsibility for the attainment of normal speech in the patient.
A glance at the numerous procedures proposed over the years affirms that the problem of achieving velopharyngeal sufficiency is not a simple one.
Several types of pushback operations to lengthen the soft palate or to bring forward the posterior pharyngeal wall were proposed. The partial closure of the velopharyngeal aperture was first attempted by Passavant1 in 1862 by suturing of the velum to the posterior pharyngeal wall. For this purpose Schoenborn2,3 used the inferiorly and the superiorly based pharyngeal flap.
Today the principles used in correcting velopharyngeal insufficiency are (1) the lengthening of the soft palate posteriorly (2)