Effect of Furlow Double Opposing Z - Plasty on Nasalance Measures in Individuals with Velopharyngeal Dysfunction: A Pre-Post Operative Comparison

Abstract

Objective:To evaluate the Effect of Furlow double opposing Z- Plasty on nasalance scores of individuals with Velopharyngeal dysfunction (VPD) and to correlate the perceptual and instrumental evaluation after surgery.Materials and method: Fifteen individuals with VPD in the age range of 7 to 25 years were considered. Preoperatively, the subjects underwent detail speech and cineradiographic evaluation. All the subjects underwent Furlow double opposing Z- Plasty. The speech samples consisted of sentences and spontaneous speech. The resonance was assessed by using nasometer II (6450) for vowels, consonant-vowel combinations, nasal and oral sentences. Post-operative speech evaluations were carried out after three months for the same tasks prior to speech therapy. The speech samples were perceptually rated by three speech language pathologists using 4 point rating scale (0 to 3). Results: There was a significant reduction in nasalance values (p=0.009<0.05) and hypernasality (p=0.025<0.05) post operatively. Moderate positive correlation (r= 0.465) was seen between perceptual rating and nasalance scores of oral sentences. Conclusion: This study highlights the need for surgical correction of VPD. However the surgical correction of velopharyngeal port does not necessarily change its function. The articulation problems may persist following surgery in some individuals and this suggests the need for speech therapy following surgical correction of VPD.