Clinical StudiesVelopharyngeal Insufficiency After Le Fort I Osteotomy in a Patient With Undiagnosed Occult Submucous Cleft PalateDang, Rushil R. DMD*; Padwa, Bonnie L. DMD, MD*,†; Resnick, Cory M. DMD, MD*,†Author Information *Department of Plastic and Oral Surgery, Boston Children's Hospital †Harvard School of Dental Medicine, Boston, MA. Address correspondence and reprint requests to Cory M. Resnick, DMD, MD, Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115; E-mail: Cory.Resnick@childrens.harvard.edu Received 27 August, 2016 Accepted 25 October, 2016 The authors report no conflicts of interest. Journal of Craniofacial Surgery: May 2017 - Volume 28 - Issue 3 - p 752-754 doi: 10.1097/SCS.0000000000003427 Buy Metrics Abstract The authors present a 16-year-old patient with no known history of cleft palate who developed velopharyngeal insufficiency after a Le Fort I osteotomy performed for the correction of maxillary hypoplasia and a Class III malocclusion. Postoperative evaluation revealed the presence of velopharyngeal insufficiency and subtle findings of an occult submucous cleft palate. She had a pharyngeal flap 6 months later with successful correction of the velopharyngeal insufficiency. This case illustrates the need to screen for submucous cleft palate prior to orthognathic surgery. © 2017 by Mutaz B. Habal, MD.