Despite successful cleft palate surgery, 10 to 30% of patients may experience abnormal speech resonance, most notably hypernasal resonance as a result of the velopharyngeal insufficiency (VPI). Surgery remains the most effective means of correcting VPI and among the popular procedures are sphincter pharyngoplasty. The purpose of this study is to compare speech hypernasality after sphincter pharyngoplasty in the management of cleft-related VPI. The study reviewed patients with velopharyngeal insufficiency who were treated by sphincter pharyngoplasty between 2015 and December 2022 by a single surgeon. The subjective evaluation of nasality was done before and after operation by at least 3 months. Hypernasality severity can be assessed using a grading system and this grading system is on a numeric scale with grade 0 being considered normal, grade 1 indicating mild hypernasality, grade 2 representing moderate hypernasality, and grade 3 indicating severe hypernasality. Of the 10 patients, 6 were female, and 4 were male. The average age of patients was 12.5 years (range, 4–27 years). All patients had moderate to severe hypernasality preoperatively, with 7 patients with severe hypernasality. All patients except one experienced an improvement in hypernasality grade following the procedure. Patients with cleft lip and palate may suffer from hypernasality, a serious problem that can impair speech and communication and can render a child’s speech unintelligible and sphincter pharyngoplasty can be a safe and effective surgical approach to correcting VPI in patients with cleft palates.
