Which member of the cleft team is primarily responsible for assessing velopharyngeal competence?

 # Which member of the cleft team is primarily responsible for assessing velopharyngeal competence?

A. Orthodontist

B. Plastic Surgeon

C. Speech-Language Pathologist

D. Otolaryngologist

The correct answer is C. Speech-Language Pathologist.

Reasoning

While the cleft palate team functions physically as a unit, the primary responsibility for assessing velopharyngeal competence (the ability of the soft palate and pharyngeal walls to separate the oral and nasal cavities during speech) lies with the Speech-Language Pathologist (SLP).

• Speech-Language Pathologist: Conducts perceptual assessments of speech (listening for hypernasality and nasal air emission) and instrumental assessments (such as nasometry). They are often the primary provider to identify velopharyngeal insufficiency (VPI) before referring for surgical or prosthetic management.

• Plastic Surgeon: Performs the surgical repair (pharyngoplasty or flap surgery) based on the assessment but relies heavily on the SLP's data regarding function.

• Orthodontist: Manages malocclusion and dentofacial growth. While maxillary advancement can affect velopharyngeal function, the orthodontist does not primarily assess the competence mechanism itself.

• Otolaryngologist (ENT): Primarily assesses and manages hearing (eustachian tube dysfunction/otitis media) and airway obstruction, rather than velopharyngeal competence for speech.