Purpose: A prospective study was done to determine whether a cleft palate repair utilizing a V-Y pharyngeal advancement flap decreased the incidence of velopharyngeal insufficiency.

Materials and Methods: Lengthening of the soft palate was performed using a V-Y pharyngeal flap along with a Von Lagenbeck repair. All the surgical procedures were performed by the same surgeon between 1985- 2004. The patients were all monitored in the Cleft Lip and Palate clinic at North Shore University Hospital. A comparison was then made between the patients who received a Von Lagenbeck repair versus those that received a Von Lagenbeck repair along with the V-Y pharyngeal flaps. The patients had an average follow up of 7.6 years with detection of VPI via nasoendoscopy or speech pathology.

Results: A decrease in the incidence of VPI was noted in the group of patients that received the palatal lengthening procedure. The incidence of VPI among the patients which did not receive added palatal lengthening via a V-Y pharyngeal flap was 37%. Among the patients that did receive the V-Y pharyngeal flap the incidence of VPI was 15%.