[Development of speech and facial skull growth after primary velopharyngoplasty in lip-jaw-palate clefts].
BACKGROUND
A two-armed, prospective, randomized study was performed to evaluate the influence of primary velopharyngoplasty on speech and facial growth in patients with cleft lip and palate.


METHODS
Forty-two patients born between 1978 and 1982 were included. All patients were treated with an intravelar veloplasty, and 21 patients simultaneously with a velopharyngoplasty according to Sanvenero-Rosselli. The patients were examined at the age of 5, 10, 15, and 18 years according to the recommendations of the research group of the German Association of Craniomaxillofacial Surgery for minimal documentation.


RESULTS
Patients treated with primary velopharyngoplasty showed a higher deficit in transversal growth of the maxilla of 0.6 mm in the molar region in adolescence in comparison to the control group. The sagittal growth of the maxilla was reduced at 2.6 degrees in the SNA angle. A statistically significant decrease in growth of the maxilla caused by primary velopharyngoplasty was not detectable (p > 0.05). The incidence of rhinophonia and dyslalia did not differ significantly. Primary velopharyngoplasty did not lead to speech improvement either in childhood or in adolescence.


CONCLUSIONS
With regard to a potential decrease in growth of the maxilla and the disadvantages of a hindered nasal respiration, a primary velopharyngoplasty therefore does not seem to be indicated.
Bolouri
S
S
Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Kiel, Arnold-Heller-Strasse 16, 24105 Kiel. bolouri@mkg.uni-kiel.de
Podzich
B
B
Terheyden
H
H
Kolbe
G
G
Dunsche
A
A
D000293:Adolescent; D002508:Cephalometry; 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; D011446:Prospective Studies; D012086:Reoperation; D013064:Speech Disorders / Q000209:etiology*; D014681:Velopharyngeal Insufficiency / Q000601:surgery*