title: Factors prognostic for phonetic development after cleft palate repair.
abstract: BACKGROUND
  Palatoplasty is aimed to achieve normal speech, improve food intake, and ensure successful maxillary growth. However, the velopharyngeal function is harder to control than other functions. Therefore, many studies on the prognostic factor of velopharyngeal insufficiency have been conducted. This study aimed to evaluate the relationships between speech outcomes and multimodality based on intraoral and preoperative three-dimensional computerized tomographic (CT) findings.
  
  
  METHODS
  Among 73 children with cleft palate who underwent palatoplasty between April 2011 and August 2014 at Kyungpook National University Hospital (KNUH), 27 were retrospectively evaluated. The 27 cases were non-syndromic, for which successful speech evaluation was conducted by a single speech-language pathologist (Table 1). Successful speech evaluation was defined as performing the test three times in 6-month intervals. Three intraoral parameters were measured before and immediately after operation (Fig. 1). On axial- and coronal-view preoperative facial CT, 5 and 2 different parameters were analyzed, respectively (Figs. 2 and 3). Regression analysis (SPSS IBM 22.0) was used in the statistical analysis.
  
  
  RESULTS
  Two-flap palatoplasty and Furlow's double opposing Z-plasty were performed in 15 and 12 patients, respectively. The operation was performed 11 months after birth on average. Children with a higher palatal arch and wider maxillary tuberosity distance showed hypernasality (p < 0.05; Table 2).
  
  
  CONCLUSIONS
  The useful prognostic factors of velopharyngeal function after palatoplasty were palate width and height, rather than initial diagnosis, treatment method, or palate length. Therefore, a more active intervention is needed, such as orthopedic appliance, posterior pharyngeal wall augmentation, or early speech training.
authors: Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Deagu 700-421, Republic of Korea.
authors: Joon Seok
authors: JS
authors: Lee
authors: Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Deagu 700-421, Republic of Korea.
authors: Jae Bong
authors: JB
authors: Kim
authors: Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Deagu 700-421, Republic of Korea.
authors: Jeong Woo
authors: JW
authors: Lee
authors: Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Deagu 700-421, Republic of Korea.
authors: Jung Dug
authors: JD
authors: Yang
authors: Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Deagu 700-421, Republic of Korea.
authors: Ho Yun
authors: HY
authors: Chung
authors: Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Deagu 700-421, Republic of Korea.
authors: Byung Chae
authors: BC
authors: Cho
authors: Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Deagu 700-421, Republic of Korea. Electronic address: kychoi@knu.ac.kr.
authors: Kang Young
authors: KY
authors: Choi
mesh_terms: D002972:Cleft Palate / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007223:Infant; D008297:Male; D009960:Oropharynx / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010159:Palate / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D021362:Palate, Hard / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010160:Palate, Soft / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010700:Phonetics; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology*; D013062:Speech Articulation Tests; D013524:Surgical Flaps / Q000637:transplantation; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: Cleft palate; High palatal arch; Hypernasality; Nasal speech