Phonetic and otological results after early palate closure in 18 consecutive children presenting with cleft lip and palate.
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.
Zanzi
Michele
M
Department of Pediatric Surgery, Chuv, 1011 Lausanne, Switzerland.
Cherpillod
Jacques
J
Hohlfeld
Judith
J
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