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The presence of the palatal fistula ( a small hole or communication between the mouth and the nose ) is seen to not only cause loss of intra-oral air pressure but also escape of air through the nose contributing to hyper nasality or nasal tone to the speech. It is a big issue with a lot patients with cleft palate. Closure of the palatal fistula can be done using multiple ways. Also, has In cases where surrounding tissue is found to be less, Dr Richardson advocates the use of Alloderm or Dermal Matrix for improved results.
Furlows double opposing Z plasty is a procedure that is performed for improving the overall speech outcome of the patient. This maneuver not only lengthens the soft palate but also helps in positioning the muscles of the soft palate in close approximation to the posterior pharyngeal wall, thereby contributing to improved speech following surgery. Regular intensive speech therapy is required for a few months after this type of surgery for best results.
The uvula is the small bit of flesh dangling down in the back of the throat. Sometimes, in adequate approximation at the time of primary cleft palate repair might leave the uvula as two separate tissues or bifid uvula. Uvuloplasty is the surgery that approximates the uvula and the muscles around it and placing it in the ideal position to contribute for overall improvement in speech.