Is the voice affected due to cleft palate?

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.