title: Phonetic and otological results after early palate closure in 18 consecutive children presenting with cleft lip and palate.
abstract: OBJECTIVE
  First, to analyze the speech and hearing results at 3.5 years of age when early palate closure has been performed. Second to assess at 7 years of age the need for speech therapy and/or additional surgery in the form of cranial-based pharyngeal flap for obtaining normal speech.
  
  
  METHODS
  Retrospective study in a tertiary teaching hospital concerning 18 consecutive cases presenting cleft lip and palate with no associated abnormalities. Interventions included early palatine closure (velum at 3 months, hard palate and lip at 6 months). Speech therapy was initiated at 3.5 years of age when needed. Cranial-based pharyngeal flap was performed when normal nasal emission was not obtained by speech therapy at 7 years of age. Phonetic and otological assessment were performed in all cases.
  
  
  RESULTS
  Good to excellent speech in the majority (95%) of children, with only 3/18 undergoing pharyngoplasty to obtain type I or I/II speech by the age of 7 (range: 6.5-8.0). 6/18 children had drain insertion, and 2/18 had hearing loss of 20-40 dB in all frequencies.
  
  
  CONCLUSIONS
  Most children (95%) start school with good or excellent speech. However, the high incidence of middle ear problems shows that more effective screening and treatment are warranted.
authors.affiliation: Department of Pediatric Surgery, Chuv, 1011 Lausanne, Switzerland.
authors.forename: Michele
authors.initials: M
authors.lastname: Zanzi
authors.forename: Jacques
authors.initials: J
authors.lastname: Cherpillod
authors.forename: Judith
authors.initials: J
authors.lastname: Hohlfeld
mesh_terms: D000158:Acoustic Impedance Tests; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000150:complications / Q000601:surgery*; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D010700:Phonetics; D011184:Postoperative Period; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013064:Speech Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D013070:Speech Therapy; D014681:Velopharyngeal Insufficiency / Q000209:etiology