title: Speech outcome in complete unilateral cleft lip and palate - a comparison of three methods of the hard palate closure.
abstract: The aim of this study was to compare the speech in subjects with cleft lip and palate, in whom three methods of the hard palate closure were used. One hundred and thirty-seven children (96 boys, 41 girls; mean age = 12 years, SD = 1·2) with complete unilateral cleft lip and palate (CUCLP) operated by a single surgeon with a one-stage method were evaluated. The management of the cleft lip and soft palate was comparable in all subjects; for hard palate repair, three different methods were used: bilateral von Langenbeck closure (b-vL group, n = 39), unilateral von Langenbeck closure (u-vL group, n = 56) and vomerplasty (v-p group, n = 42). Speech was assessed: (i) perceptually for the presence of a) hypernasality, b) compensatory articulations (CAs), c) audible nasal air emissions (ANE) and d) speech intelligibility; (ii) for the presence of compensatory facial grimacing, (iii) with clinical intra-oral evaluation and (iv) with videonasendoscopy. A total rate of hypernasality requiring pharyngoplasty was 5·1%; total incidence post-oral compensatory articulations (CAs) was 2·2%. The overall speech intelligibility was good in 84·7% of cases. Oronasal fistulas (ONFs) occurred in 15·7% b-vL subjects, 7·1% u-vL subjects and 50% v-p subjects (P < 0·001). No statistically significant intergroup differences for hypernasality, CAs and intelligibility were found (P > 0·1). In conclusion, the speech after early one-stage repair of CUCLP was satisfactory. The method of hard palate repair affected the incidence of ONFs, which, however, caused relatively mild and inconsistent speech errors.
authors: Laboratory of Speech Pathology and Upper Airway Endoscopy, Institute of Mother and Child, Warsaw, Poland; Department of Otolaryngology and Maxillofacial Surgery, Universitary Clinical Hospital, Olsztyn, Poland.
authors: M
authors: M
authors: Hortis-Dzierzbicka
authors: E
authors: E
authors: Radkowska
authors: E
authors: E
authors: Stecko
authors: L
authors: L
authors: Dudzinski
authors: P S
authors: PS
authors: Fudalej
mesh_terms: D000293:Adolescent; D002648:Child; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology; D013065:Speech Intelligibility / Q000502:physiology*; D016896:Treatment Outcome
keywords: articulation disorder; cleft lip; cleft palate; speech