Palatoplasty for an elderly patient with cleft palate: a case of veropharyngeal insufficiency caused by a large defect in the soft palate

Some cases of untreated cleft palate have been reported in elderly persons in Japan. Recently, such cases are rare because babies with a cleft palate can receive systematic treatment owing to the healthcare system in Japan.We report on a 63-year-old man with a large defect in the soft palate caused by cleft palate. The patient was referred to our clinic because of nasal leakage of water. The large defect, measuring 35 by 12mm, caused velopharyngeal insufficiency during speech. The patient had received primary palatoplasty once during his childhood, but the details were unclear because both of his parents had died while he was still a child. The patient underwent closure of the fistula in his soft palate by the repush back method. Eighteen months after surgery, the patient was able to blow and speak single words without nasal leakage. Fiberscopic examination revealed complete closure of the velopharyngeal space during speech.