Skip to main content

New measurement techniques for the assessment of velopharyngeal function in cleft palate patients

Birch, Malcolm John (1995) New measurement techniques for the assessment of velopharyngeal function in cleft palate patients. Doctor of Philosophy (PhD) thesis, University of Kent. (doi:10.22024/UniKent/01.02.86194) (KAR id:86194)

Language: English

Click to download this file (23MB)
[thumbnail of 337318.pdf]
This file may not be suitable for users of assistive technology.
Request an accessible format
Official URL:


The present day treatment of the cleft palate is very much a multi-disciplinary team approach calling upon the skills of plastic surgeon, orthodontist, maxillo-facial surgeon and speech therapist. The aesthetic result of modern plastic surgery on the lip and face is unquestionably successful; however the improvement to speech due to changes in velopharyngeal function as a result of surgery is not so readily agreed upon. It is generally acknowledged that cleft repair should be carried out as early as possible after birth followed by several years of developmental monitoring; however considerable debate relating to the surgical technique employed and the long term effect of surgery on speech development still abounds.

This thesis undertakes to make a contribution to the debate of efficacy of cleft repair in relation to speech function in the following manner. Firstly a new instrument called a Nasal Resonometer has been specifically designed for use by speech therapists for the pre and post operative assessment of hyper- and hypo-nasal speech. Secondly a new measurement technique involving the computer assisted analysis of x-ray videofluoroscopy images of clinically significant aspects of velar function has been introduced.

Several studies of patients attending the clef repair clinics over a three year period are presented. The correlations between objective Resonometer measurement, subjective speech therapist analysis, velopharyngeal function and surgical technique are examined.

The extensive clinical use of the Nasal Resonometer and image analysis technique have proven to be a successful addition to routine cleft palate measurements. Further the application of these measurements in specific studies has led to a clearer understanding of the effect of cleft palate surgery and has highlighted future areas of research.

Item Type: Thesis (Doctor of Philosophy (PhD))
DOI/Identification number: 10.22024/UniKent/01.02.86194
Additional information: This thesis has been digitised by EThOS, the British Library digitisation service, for purposes of preservation and dissemination. It was uploaded to KAR on 09 February 2021 in order to hold its content and record within University of Kent systems. It is available Open Access using a Creative Commons Attribution, Non-commercial, No Derivatives ( licence so that the thesis and its author, can benefit from opportunities for increased readership and citation. This was done in line with University of Kent policies ( If you feel that your rights are compromised by open access to this thesis, or if you would like more information about its availability, please contact us at and we will seriously consider your claim under the terms of our Take-Down Policy (
Uncontrolled keywords: surgical repair; Nasal resonometer; cleft palates
Subjects: R Medicine > R Medicine (General)
SWORD Depositor: SWORD Copy
Depositing User: SWORD Copy
Date Deposited: 29 Oct 2019 16:33 UTC
Last Modified: 10 Dec 2022 07:48 UTC
Resource URI: (The current URI for this page, for reference purposes)
  • Depositors only (login required):

Total unique views for this document in KAR since July 2020. For more details click on the image.