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All too often the palate is not only cleft but short as well, and both defects prevent proper velopharyngeal closure and result in poor speech. Roux first drew attention to congenital insufficiencies of the palate in 1825. It is important to determine preoperatively whether velopharyngeal insufficiency exists, if it sloes, the surgeon should select an operative procedure that will remedy it. We have at our disposal two different types of operation to correct velopharyngeal insufficiency: (1) those-which: achieve retrodisplacement of the palate (push back)? and (2), operation on post pharyngeal wall (pharyngeal flaps), We prefer the former because of simpler postoperative care, but in some cases of acutely angulated palatal dome, the push back is technically complicated in performance of routin Veau-Trauner methods. In the cases presented, we used a relaxation Z-plasty on the nasal mucosa in the junctional areas of hard & soft palate to obtain succesful push back, as suggested by Kilner.´The additional lengthening after push back ranged from 5 mm. to 10 mm.. The palatal development was obscured in only soft palate in cleft palate patients as compare to uncleft palate children.
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