Nasalance measurements as outcome indices for palatal lift management: Lift in versus lift out

Prosthetic management of velopharyngeal incompetence with a palatal lift is now advocated for patients who have structurally adequate but dysfunctional velopharyngeal mechanisms. Additional data are needed to examine the effectiveness of a palatal lift for the broad variety of patients who receive such management. The purpose of this research was to determine the degree of change in oronasal speech quality due to the presence of a palatal lift in patients for whom a palatal lift had been constructed. Nineteen patients who had been fitted with a palatal lift were examined as part of their routine clinical management. Ratings of hypernasal resonance and hyponasal resonance were recorded when the lift was removed and when it was in place. Nasalance measures were also obtained with the lift in place and with the lift removed. Mean group ratings of hypernasality were significantly reduced, and mean group ratings of hyponasality were significantly increased. Mean group nasalance measures were similarly altered by the presence of the lift. Considerable variability was found among the patients, a finding that supports careful consideration of individual patient characteristics when palatal lift management is being planned.