Palatoplasty for cleft lip and palate is associated with two major complications speech development disorders, including velopharyngeal insufficiency, and maxillary growth disturbance. Current study aimed to assess velopharyngeal incompetence and anatomical factors contributing to incomplete closure following cleft palate repair and to evaluated the patients after the surgical procedure and attempted to recommend an appropriate management strategy. Materials and Methods: A prospective observational study was conducted from January 2011 to January-2013. A total of 28 patients with operated cleft palate having clinical features of velopharyngeal insufficiency were included in the study. Patients were evaluated by history, physical examination, Video fluoroscopy, Nasoendoscopy. Velopharyngeal gap size and closure pattern were taken into account based on the endoscopy report. Velopharyngeal gap size was rated on a four-point scale. Results: Among our study participants, 9 (32%) were aged between 11 to 15 years, and 16 (57%) were males. Out of 28 cases with velopharyngeal incompetence, who were assessed endoscopically, the distribution of closure pattern was circular in 20(72%) cases. There were no patients found with sagittal closure pattern. Conclusion: Our study concluded that Surgical correction of VPI improves speech and patients are advised speech therapy to improve the compensatory articulations.

The maxillofacial region of the face with its complexity is prone to injuries. The epidemiology and clinical presentation of these injuries can help in determining the prognosis and management and undertaking measures for prevention. The objective of this study was to assess the patterns of clinical presentation of maxillofacial fractures and associated injuries presenting to a tertiary care centre in Hyderabad and to determine the association between the fracture patterns and the mechanism of injury. Material and methods: A prospective, clinical study of fractures of the maxillofacial region was carried out on 411 subjects from January 2011 to January 2013 in Osmania Medical College and Hospital, Hyderabad. The diagnosis was based on a detailed history and thorough clinical examination, confirmed by radiograph. Data were entered in Microsoft Excel and analysed with SPSS statistical software version 20. Results: Major proportion (48%) of the subjects were in the age group of 21 to 30 years. The majority (90%) were males. RTA (Road traffic accidents) was the main risk factor (75%) for maxillofacial fractures, followed by assaults (17%) and falls (8%). Mandible (47.9%) was the most frequent location of the fracture. Isolated fractures of the mandible occurred in 45.74% of cases, and pan facial fractures occurred in 12.65%. Conclusions: Majority of the fractures affect the young men in their third decade of life. RTA continues to be the chief etiological factor in maxillofacial fractures. Mandible in the most common bone affected, followed by panfacial fractures.