The outcome of long-term follow-up after palatoplasty.
The speech outcome was studied retrospectively in 140 cleft-palate patients who underwent push-back palatoplasty. Velopharyngeal function and articulation disorders were evaluated serially at 4, 7, 10, and more than 10 years of age. On comparison of velopharyngeal function between 4 years of age and the most recent review (>10 years), it was unchanged in 90 patients (64.3 percent), whereas it showed deterioration in 14 patients and showed improvement in 8 patients. The other 28 patients underwent pharyngeal flap surgery; this group also included patients with functional deterioration. Changes of velopharyngeal function often occurred between 4 and 7 years of age but sometimes occurred after 10 years of age. Articulation disorders were observed in 49 subjects (35.0 percent) at 4 years of age. Many of the patients with glottal stop showed improvement from 4 to 7 years of age. Palatalized articulation showed less improvement than glottal stop (p < 0.01). The number of patients with articulation disorders decreased significantly between 4 years of age and the most recent review (p < 0.001). These findings suggest that speech does not become stable before 10 years of age and that patients with cleft palate should be carefully followed until they are beyond this age.
Park
S
S
Department of Plastic and Reconstructive Surgery at Kagawa Medical University, Japan. spark@kms.ac.jp
Saso
Y
Y
Ito
O
O
Tokioka
K
K
Takato
T
T
Kato
K
K
Kitano
I
I
D000293:Adolescent; D000328:Adult; D001184:Articulation Disorders / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010159:Palate / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D013062:Speech Articulation Tests; D013064:Speech Disorders / Q000209:etiology*; D013068:Speech Production Measurement; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000209:etiology; D014833:Voice Quality