Speech outcome and maxillary growth in patients with unilateral complete cleft lip/palate operated on at 6 versus 12 months of age.
A prospective study of speech outcome and maxillofacial growth was carried out in cleft palate patients. Seventy-six cleft palate patients were randomly selected for the study group; 41 patients were operated on at 12 months of age, and 35 patients were operated on at 6 months of age. All patients were followed until they were 4 years of age. All patients underwent a complete speech evaluation, videonasopharyngoscopy, videofluoroscopy, and maxillofacial assessment. The rate of velopharyngeal insufficiency did not differ between the two groups (17 to 19 percent; p > 0.05). However, phonologic development was significantly better (p < 0.05) in the patients operated on at 6 months of age. Furthermore, none of the patients operated on at 6 months of age showed compensatory articulation disorder. In contrast, 62 percent of the patients with postoperative velopharyngeal insufficiency operated on at 12 months of age showed compensatory articulation disorder (p < 0.05). Maxillofacial assessment showed that there were non-significant differences (p > 0.05) in maxillofacial growth in both groups of patients. All patients showed similar degrees of maxillary collapse (p > 0.05). The results of this study suggest that cleft palate repair performed at 6 months of age significantly enhances speech outcome and prevents compensatory articulation disorder.
Ysunza
A
A
Department of Phoniatrics, Hospital Gea González, Mexico City, Mexico.
Pamplona
M C
MC
Mendoza
M
M
García-Velasco
M
M
Aguilar
M P
MP
Guerrero
M E
ME
D001184:Articulation Disorders / Q000209:etiology* / Q000503:physiopathology; D002508:Cephalometry; D002675:Child, Preschool; D002971:Cleft Lip / Q000503:physiopathology / Q000601:surgery*; D002972:Cleft Palate / Q000503:physiopathology / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008445:Maxillofacial Development / Q000502:physiology*; D010614:Pharynx / Q000503:physiopathology / Q000601:surgery; D010699:Phonation / Q000502:physiology; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D013062:Speech Articulation Tests; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology / Q000601:surgery; D014741:Video Recording