Q: I had cleft soft palate. I was operated at the age of 1 and half years. Every thing is OK but my voice remained somewhat defective. I consulted a plastic surgeon in Bombay hospital and Hinduja hospital. They said that my voice is good up to 80% and I should not go through any surgical intervention because of risk involved in surgery. But it appears that my voice is different from others. Will some remedy either surgical/medical be of any help to me?

A:Patients with cleft palate usually have some degree of speech defects. This is mainly in the form of a nasal twang. This occurs because air escapes through the nose since the palate is short. You need to be evaluated: 1. by a speech therapist, if some improvement can be brought about by training. 2. for velo-pharyngeal incompetence - which essentially means to find out if your palate is very short. In such cases, an additional surgical procedure (pharyngoplasty) can help. I must say that the speech can never be 100% normal, so you have to critically assess if additional surgery can make a substantial improvement.