title: Adult Quality of Life Post Cleft Palate Repair: A Comparison of Two Techniques.
abstract: OBJECTIVE
  In 1989, the Cleft Palate-Craniofacial Journal published the first randomized prospective cleft surgery study, comparing the Kriens intravelar veloplasty (IVV) with a non-IVV 2-flap repair. Results in that and follow-up publications yielded no difference between the 2 groups for need for secondary velopharyngeal management. The subjects have now reached adulthood. This study was designed to ask: Is there any difference between the groups in the outcomes that multidisciplinary team care addresses: speech intelligibility, facial growth, breathing while awake and asleep, attainment of education, and long-term socioeconomic status?
  
  
  METHODS
  Enrollees from the original published study were invited to participate in a survey. Subjects responded to questions about speech therapy and speech satisfaction, additional surgery, breathing patterns, sleep quality/sleep disorder, and dental occlusion. Demographic information, information on education level, profession, and socio-economic status were queried. Student t test and Fisher exact test were used to compare results.
  
  
  RESULTS
  Forty-two of the original 200 patients (20 Kriens IVV and 19 non-IVV) chose to participate. Average age at survey was 25 ± 3 years. Analysis yielded no difference between the 2 respondent groups for need for secondary velopharyngeal management. There were no differences in speech outcome and satisfaction (8 questions, 0.30 < P < 0.97), sleep concerns (3 questions, 0.16 < P < 0.39), and dental occlusion (P = 0.69). Equivalent proportions of the 2 groups had been in speech therapy (P = 0.22). There was no difference in education attainment of the 2 groups (P = 0.26).
  
  
  CONCLUSIONS
  The original randomized prospective trial suggested that there was no difference between the 2 surgery types in need for secondary velopharyngeal management. This long-term survey study on the same group of patients suggests that in young adulthood, the 2 groups have similar outcomes in terms of education, career choice, speech satisfaction, dental occlusion, and sleep disorder.
authors.affiliation: *Washington University School of Medicine in St Louis †St Louis Children's Hospital ‡Kids Plastic Surgery, St Louis, MO §Alpert School of Medicine, Brown University, Providence, RI.
authors.forename: Rachel
authors.initials: R
authors.lastname: Skladman
authors.forename: Lynn Marty
authors.initials: LM
authors.lastname: Grames
authors.forename: Gary
authors.initials: G
authors.lastname: Skolnick
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Nguyen
authors.forename: Sybill D
authors.initials: SD
authors.lastname: Naidoo
authors.forename: Kamlesh B
authors.initials: KB
authors.lastname: Patel
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Marsh
authors.forename: Albert S
authors.initials: AS
authors.lastname: Woo
mesh_terms: D000328:Adult; D002972:Cleft Palate / Q000150:complications / Q000601:surgery*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012119:Respiration; D012893:Sleep Wake Disorders / Q000209:etiology; D012923:Social Class; D013064:Speech Disorders / Q000209:etiology / Q000628:therapy; D013065:Speech Intelligibility; D013070:Speech Therapy; D016896:Treatment Outcome; D055815:Young Adult