Inclusion Criteria:  Patients with isolated cleft palate age from 9 months to 18 years. Patients with submucous cleft. Velopharyngeal incompetence (VPI) for palatal re-repair.  Exclusion Criteria:  Medically unfit patients. Syndromic patients with cleft lip and palate. Patients with cleft palate associated with multiple congenital anomalies. Patients with neurological disorders.