title: [Speech outcome after simple and multiple cleft palate operations].
abstract: OBJECTIVE
  If the primary palatal closure in a patient with cleft lip and palate is unsuccessful, defects such as palatal fistulas and a short velum have to be corrected by secondary operations. It is an informal belief among surgeons that these reoperations can have detrimental effects on the patients' nasal resonance and articulation. It was our aim to critically evaluate the validity of this belief.
  
  
  METHODS
  One hundred and twenty-four patients with cleft lip and palate were divided into three groups. The 70 patients in group 1 had only undergone a primary palatal closure operation. The 33 patients in group 2 had undergone one or more palatal reoperations. The 21 patients in group 3 had undergone an additional pharyngeal flap operation. Resonance and articulation were evaluated perceptually. Nasalance was assessed with the NasalView system, and the mean speech rate was analyzed with the MODIAS software.
  
  
  RESULTS
  There were no significant differences for any of the speech measures between groups 1 and 2. Patients in group 3 had significantly worse results for all speech measures.
  
  
  CONCLUSIONS
  The speech outcomes for patients with multiple palatal reoperations were no different from those of patients with single palatal closure operations. The pharyngeal flap operation did not lead to sufficient improvements in the speech of the patients in group 3.
authors.affiliation: Graduate Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, 6 Queen's Park Crescent West, Toronto ON M5S 3H2, Kanada. tim.bressmann@utoronto.ca
authors.forename: T
authors.initials: T
authors.lastname: Bressmann
authors.forename: R
authors.initials: R
authors.lastname: Sader
authors.forename: P
authors.initials: P
authors.lastname: Jürgens
authors.forename: H F
authors.initials: HF
authors.lastname: Zeilhofer
authors.forename: H H
authors.initials: HH
authors.lastname: Horch
mesh_terms: D000293:Adolescent; D000328:Adult; D001184:Articulation Disorders / Q000209:etiology*; D002648:Child; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D012086:Reoperation; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted; D013018:Sound Spectrography; D013064:Speech Disorders / Q000209:etiology*; D014833:Voice Quality