Treatment of Velopharyngeal Insufficiency: Fifteen-Year Experience at the University of Florida.

INTRODUCTION: A 15-year experience treating velopharyngeal insufficiency at the University of Florida is presented. After diagnostic speech evaluation, preoperative videofluoroscopy was the primary method used to evaluate the function of the velopharyngeal port. METHODS: Chart reviews of all patients with velopharyngeal insufficiency, including patients with failed palatal cleft surgery, submucous cleft palate, and noncleft palate who met study criteria were included. RESULTS: Overall success of treatment was 92%. Results are described by subgroups for further clarification. CONCLUSION: Selection of surgical procedure based on preoperative evaluation of velopharyngeal function and anatomy leads to a high rate of success.

Longitudinal study of growth of children with unilateral cleft-lip palate from birth to two years of age.

OBJECTIVE: To study the growth of children with complete unilateral cleft lip and palate (UCLP) from birth to 2 years of age and to construct specific UCLP growth curves. DESIGN: Physical growth was a secondary outcome measure of a National Institutes of Health-sponsored longitudinal, prospective clinical trial involving the University of Florida (United States) and the University of São Paulo (Brazil). PATIENTS: Six hundred twenty-seven children with UCLP, nonsyndromic, both genders. METHODS: Length, weight, and head circumference were prospectively measured for a group of children enrolled in a clinical trial. Median growth curves for the three parameters (length, weight, head circumference) were performed and compared with the median for the National Center for Health Statistics (NCHS) curves. The median values for length, weight, and head circumference at birth and 6, 12, 18, and 24 months of age were plotted against NCHS median values and statistically compared at birth and 24 months. SETTING: Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, Brazil (HRAC-USP). RESULTS: At birth, children of both genders with UCLP presented with smaller body dimensions in relation to NCHS median values, but the results suggest a catch-up growth for length, weight, and head circumference for girls and for weight (to some degree) and head circumference for boys. CONCLUSIONS: Weight was the most compromised parameter for both genders, followed by length and then head circumference. There was no evidence of short stature. This study established growth curves for children with UCLP.