THE SUDDEN BEGBESSION of speech following adenotonsillectomy in the child with a repaired cleft palate is a surgical tragedy. Usually this happens when the surgeon performing the procedure is unaware of the delicate balance of speech performance in these children. Speech regression may occur not only in the child with cleft palate, but also in any case of insufficient palatal function, including the congenitally short palate, the submucous cleft of the soft palate, the atresic palate, the soft palate with a bifid uvula, and the functionally deficient palate.
The attainment of good speech after the surgical correction of a palatal deformity is a gratifying reward to all participating in the care of the patient. Often this attainment requires the joint efforts of the plastic surgeon, speech therapist, otolaryngologist, orthodontist, and other special therapists. The sudden loss of the precious acquisition of good speech is ordinarily avoidable, but the surgeon contemplating