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Background: In patients with lip-cleft-palate malformations, an abnormal speech outcome in terms of acceptance and intelligibility can persist despite previous regular surgical treatment. According to international standards, speech therapists (SLTs) are part of the interdisciplinary team that is supposed to assess the indication of velopharyngeal plastic (VPP) for cleft patients (DGMKG, DGZMK, 2024). The examination of speech function by SLTs is usually based on a multi-layered assessment of findings. This can be overlaid or even distorted by interacting factors that are sometimes diSicult to diSerentiate. This raises the question to which extend a selection of certain measuring points would allow a precise and eSicient indication of a VPP. Since, to our knowledge, no step-by-step diagnostics for the indication of VPP from a speech therapy perspective exists to date, this will be developed and presented.
Method A previous expert survey of clinically experienced speech therapists will be conducted to determine both the number and type of measurement points that appear relevant. Subsequently, on the basis of already existing validated procedures and relevant literature, certain parameters will be defined, categorized and specific measurement methods will be derived. Finally this will be chronologically presented in a flowchart.
Discussion At present, validated, often time-consuming procedures are already available for estimating a VPI. The step-by-step diagnostics discussed here is intended to make the complexity of parameters clinically applicable and eSicient and thus may provide a basis for the interdisciplinary discussion in the process of recommending a VPP.
DGMKG, DGZMK: “Therapy of lip and palate malformations”, long version, version 1, 2024, AWMF registration number: 007-038, https://register.awmf.org/de/leitlinien/detail/007- 038 (19.02.2025)
