Study On Facial Grimace And Degree And Patterns Of Velopharyngeal Closure In Patients With Velopharyngeal Insufficiency After Cleft Palate Surgery

Objective: To study the relationship between facial grimace and degree and patterns of velopharyngeal closure in patients with velopharyngeal insufficiency after cleft palate surgery.Methods: Seventy-five repaired cleft palate patients with complete nasopharyngeal endoscopy and speech assessments were selected to observe and record their facial grimace and analyze the velopharyngeal closure ratios and patterns during pronunciation,dividing closure ratios into mild(velopharyngeal closure ratios > 70%),moderate(velopharyngeal closure ratios between 40%-70%),and severe(velopharyngeal closure ratios < 40%);classifing closure patterns into coronal,circular and other types of closure,analyzing their relationship to facial grimace.Results: The incidence of facial grimace in patients who accepted cleft palate surgery less than 2 years and older than 2years were 41.38% and 58.70%,respectively,and there was no statistical significance(P >0.05).However,there was a statistically significant difference between facial grimace and degree and pattern of velopharyngeal closure.The incidence of facial grimace in patients with mild,moderate and severe velopharyngeal insufficiency was 37.04%,70.27% and27.27%,respectively,and the difference was statistically significant(P < 0.05).Results Pairwise comparison showed that the incidence of facial was higher in the moderate group than in the mild and severe group,there was no statistically significant difference between the mild and severe group(P > 0.017).The incidence of facial grimace in patients with coronal,annular and other types of velopharyngeal closure was 42.42%,58.62% and61.54%,respectively,and there was no statistical significance(P > 0.05).Conclusion:These preliminary findings indicate that the facial grimace mainly occurs in patients with moderate velopharyngeal insufficiency.For patients with severe velopharyngeal insufficiency,the articulatory errors is mainly manifested as omission,substitution and compensatory,so the incidence of facial grimace is relatively low.Age of surgery and velopharyngeal closure patterns had no effect on facial grimace.