Long-Term Management of Velopharyngeal Insufficiency and Misarticulation in Unilateral Cleft Lip and Palate: Speech Therapy Outcomes

This report highlights the long-term management of velopharyngeal insufficiency (VPI) and misarticulation in an 18-year-old male with unilateral cleft lip and palate. Despite primary and secondary surgeries, persistent VPI required a speech appliance and intensive therapy to address glottal stops and pharyngeal fricatives. While therapy eliminated these errors, residual VPI continued to impact speech intelligibility. Reassessment revealed that while some <i>misarticulations persisted</i>, the patient retained <i>speech improvements from prior therapy</i>, allowing for <i>partial substitutions of target sounds</i>. This case emphasizes the role of speech therapy in managing misarticulation despite unresolved VPI and highlights the need for ongoing multidisciplinary care.