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Journal of the Korean Cleft Palate-Craniofacial Association 2010;11(2):73-76.
Post-operative Continuous Positive Airway Pressure (CPAP) Therapy in Velopharyngeal Insufficiency Patient.
Kyu Nam Kim, Kyung Suck Koh, Seung Eun Jung, Seung Hee Ha, Mi Kyung Park
1Department of Plastic Surgery, University of Ulsan, College of Medicine, Korea. psbear@empas.com
2Department of Rehabilitation Medicine, University of Ulsan, College of Medicine, Korea.
3Division of Speech Pathology and Audiology, Hallym University, Korea.
4Department of Plastic Surgery, Seoul National University Bundang Hospital, Korea.
Abstract
PURPOSE
There are several surgical methods for correcting a velopharyngeal insufficiency (VPI) but in some cases, it is not possible to achieve complete recovery of the velopharyngeal function. This paper introduces a new therapy for treating hypernasality without further surgery using continuous positive airway pressure (CPAP). METHODS: CPAP therapy was applied to seven VPI patients for eight weeks from April of 2007 to September of 2009. All patients underwent palatoplasty for the cleft palate and six patients underwent palatal lengthening for VPI before CPAP therapy. A speech pathologist performed an auditory perceptual evaluation to evaluate the improvement in hypernasality after 8-week CPAP therapy.
RESULTS
Six patients showed an improvement in hypernasality after CPAP therapy according to the auditory perceptual evaluation. One patient with severe hypernasality responded to the early part of therapy but the hypernasality did not improve after therapy.
CONCLUSION
CPAP therapy might be effective in reducing the hypernasality in patients with VPI by providing resistance training to strengthen the velopharyngeal closure muscles. In particular, CPAP therapy could be more effective for patients who show mild to moderate hypernasality after surgery.
Keywords: Continuous positive airway pressure (CPAP); Hypernasality; Velopharyngeal insufficiency
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