title: Incidence of postoperative velopharyngeal insufficiency in late palate repair.
abstract: BACKGROUND
  This was a study of patients with cleft palate who for various reasons have their first hospital visit for palatal repair at an older age in developing countries. The aims of this study were to investigate the incidence of postoperative velopharyngeal insufficiency in Chinese patients with late palatal repair and to determine the relative importance of age at palatoplasty, cleft type, surgical technique, and experience for clinical outcomes.
  
  
  METHODS
  A cohort of 224 patients who underwent primary palate repair were studied retrospectively. Speech outcomes were evaluated based on the severity of hypernasality and nasal emission. The percentage of cases that required a second operation was recorded. The related factors were analyzed, and a logistic regression model was applied.
  
  
  RESULTS
  The mean age at palatoplasty was 5.6 (SD, 4.6) years (age range, 2-24 years of age); 29.9% of the cases required a second operation. Age at palatoplasty was the only significant contributing factor for the percentage of patients who needed a second surgery. Each additional year in age at palatoplasty was associated with a 10.8% increase in odds of requiring a second surgery (P = 0.002; odds ratio, 1.108; confidence interval, 1.038-1.182). However, cleft type, surgical technique, and surgeon's experience did not influence clinical outcomes.
  
  
  CONCLUSIONS
  Primary palate repair at older than 2 years resulted in acceptable clinical speech outcomes in our patient population, there was an increase in the incidence of postoperative velopharyngeal insufficiency with increasing age at the time of palatoplasty. There was no correlation with cleft type, surgical technique, or surgeon's experience.
authors.affiliation: Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Shufan
authors.initials: S
authors.lastname: Zhao
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
authors.forename: Heng
authors.initials: H
authors.lastname: Yin
authors.forename: Qian
authors.initials: Q
authors.lastname: Zheng
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Tianhang
authors.initials: T
authors.lastname: Zhong
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.forename: Bing
authors.initials: B
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002681:China; D002972:Cleft Palate / Q000601:surgery*; D003906:Developing Countries; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013064:Speech Disorders / Q000453:epidemiology; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000453:epidemiology*