Superiorly based pharyngeal flap

Velopharyngeal incompetence may be either congenital or acquired in origin. Congenital defects not only exist as an obvious cleft in the palate but the incompetence may also be a result of more subtle defects such as submucous cleft, platybasia, congenital short palate, or cervical spine deformity. Acquired defects are usually more obvious. Postinflammatory or postirradiation cicatrization and defects after surgical resection are the usual causes, but palate paralysis secondary to neurologic disease and palatal incompetency following adenoidectomy, should also be considered.