Speech results after one-stage palatoplasty with or without muscle reconstruction for isolated cleft palate.
OBJECTIVE
To investigate speech outcome between children with isolated cleft palate undergoing palatoplasty with and without muscle reconstruction and to compare speech outcomes between cleft and non cleft children. The number of subsequent velopharyngeal flaps was compared with respect to surgical techniques and cleft extent.


METHODS
Cross-sectional retrospective study.


METHODS
One hundred four children aged 4 years, 0 months to 6 years, 0 months, 33 with isolated cleft of the soft palate, 53 with isolated cleft of the hard and soft palate, and 18 non cleft children.


METHODS
Two primary palate repair techniques: minimal incision technique (MIT) and minimal incision technique including muscle reconstruction (MIT(mr)).


METHODS
Perceptual judgment of seven speech parameters assessed on a five-point scale.


RESULTS
No significant differences in speech outcomes were found between MIT and MIT(mr) surgery groups. The number of velopharyngeal flaps was significantly lower after MIT(mr) surgery compared to MIT surgery. The number of flaps was also significantly lower in children with cleft of the soft palate compared to children with cleft of the hard and soft palate. Children with cleft of the soft palate had significantly less glottal articulation and weak pressure consonants compared to children with cleft of the hard and soft palate.


CONCLUSIONS
The MIT(mr) surgery technique was not significantly superior to the MIT technique regarding speech outcomes related to velopharyngeal competence, but had fewer velopharyngeal flaps, which is contradictory. Until a larger sample can be studied, we will continue to use MIT(mr) for primary palate repair.
Nyberg
Jill
J
Department of Speech Pathology, Karolinska University Hospital, Solna, Sweden.
Westberg
Liisi Raud
LR
Neovius
Erik
E
Larson
Ola
O
Henningsson
Gunilla
G
D001184:Articulation Disorders / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000150:complications / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D019647:Oral Surgical Procedures / Q000379:methods*; D010156:Palatal Muscles / Q000601:surgery*; D021362:Palate, Hard / Q000601:surgery; D010160:Palate, Soft / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013524:Surgical Flaps; D014681:Velopharyngeal Insufficiency / Q000150:complications* / Q000209:etiology; D014832:Voice Disorders / Q000209:etiology*