Treatment of Patients With Cleft Palate in Consideration of Nasal Breathing and Speech-Reply

In Reply .—We appreciate the opportunity to respond to Finkelstein's comments regarding our article "Effects of Cleft Lip and Palate on the Nasal Airway in Children" in the September issue of theArchives. 1 Since Finkelstein quoted an earlier article of ours 2 that concerned the functional role of the soft palate in phonation and breathing, it is obvious that we both agree that speech and breathing are integrated acts. In fact, this study was part of a much broader investigation of speech and breathing in children and adults with cleft palate. The speech aspects of the study have been published in a number of recent articles, 3-5 and more are in press. 6,7 That article reported only the breathing components in children; aspects covering adults have also been described 8,9 or are in press. 10,11 Since we agree on the basic issue, let us consider Finkelstein's real concerns. That is,