Treating children with cleft lip and palate is one of the most difficult tasks in reconstructing maxillofacial area. The problem is not only in the correction of the anatomical deformity, but also in restoring function of the organ. The pursuit of an objective diagnosis of the causes listed above, involved 37 years of clinical experience, which includes the use of complex diagnostics and the implementation of the comprehensive rehabilitation of a large group of patients with VPI, led to the creation of our classification, built on a quantitative assessment of anatomic and functional characteristics of the function of structures VPR defined on the basis of endoscopy Anatomo-functional endoscopic classification of velopharyngeal ring (Ad. Mamedov, 1996). I type – velopharyngeal insufficiency, developed due to poor excursion of palatine velum (PV) II type – velopharyngeal insufficiency developed due to poor mobility of one lateral pharyngeal wall. III type – velopharyngeal insufficiency developed due to the poor mobility of both lateral pharyngeal walls. IV type – velopharyngeal insufficiency developed due to poor mobility of all structures of the velopharyngeal ring. V type – velopharyngeal insufficiency developed after velopharyngoplasty, pharyngoplasty. The proposed classification (grouping the causes of the failure of the function of structures of VPR) allows in practice the choice of surgical treatment, each of which are defined and used in the surgery of the least mobile of tissue structures of VPR. Determination of the degree of mobility of each of the structures of fragments, and all together allows us to recommend a particular surgical method, aiming to correct the least mobile of tissues and eliminate their negative impact on the mechanism of closure of VPR.
Key words : velopharyngeal insufficiency; endoscopic classification