title: Limited Chances of Speech Improvement After Late Cleft Palate Repair.
abstract: Late primary palatal repair is a common phenomenon, and many patients across the world will be operated on at a far later age than is suggested for normal speech development. Nevertheless, little is known about the speech outcomes after these procedures and conflicting results exist among the few studies performed. In this study, blinded preoperative and postoperative speech recordings from 31 patients operated on at Guwahati Comprehensive Cleft Care Center in Assam, India, older than 7 years were evaluated. Six non-Indian speech and language pathologists evaluated hypernasal resonance and articulation, and 4 local laymen evaluated the speech intelligibility/acceptability of the samples. In 25 of 31 cases, the evaluators could not detect any speech improvement in the postoperative recordings. A clear trend of postoperative improvement was only found in 6 of the 31 patients. Among these 6 patients, lesser clefts were overrepresented. Our findings together with previous studies suggest that late palate repairs have the potential to improve speech, but the probability for improvement and degree of improvement is low, especially in older adolescents and adults with complete clefts.
authors.affiliation: *Guwahati Comprehensive Cleft Care Centre, Mahendra Mohan Choudhury Hospital Panbazar, Guwahati, Assam, India †Department of Plastic and Reconstructive Surgery, Skane University Hospital, Malmo, Sweden ‡Department of Speech and Language Pathology, Stockholm Craniofacial Team, and Department of Reconstructive and Plastic Surgery, Karolinska University Hospital, Solna, Sweden §Operation Smile, Virginia Beach, VA ||Division of Plastic Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA.
authors.forename: Björn
authors.initials: B
authors.lastname: Schönmeyr
authors.forename: Lisa
authors.initials: L
authors.lastname: Wendby
authors.forename: Mitali
authors.initials: M
authors.lastname: Sharma
authors.forename: Liisi
authors.initials: L
authors.lastname: Raud-Westberg
authors.forename: Carolina
authors.initials: C
authors.lastname: Restrepo
authors.forename: Alex
authors.initials: A
authors.lastname: Campbell
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002972:Cleft Palate / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013064:Speech Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D013065:Speech Intelligibility / Q000502:physiology*; D055815:Young Adult