Positional Therapy and Palatal Surgery

Abstract Background When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-). Methods One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed. Results In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group. Conclusions The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.

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Speech and Phonology in Swedish-Speaking 3-Year-Olds with Unilateral Complete Cleft Lip and Palate following Different Methods for Primary Palatal Surgery

The Cleft Palate-Craniofacial Journal ◽

10.1597/12-299 ◽

2014 ◽

Vol 51 (3) ◽

pp. 274-282 ◽

Cited By ~ 16

Author(s):

Kristina Klintö ◽

Henry Svensson ◽

Anna Elander ◽

Anette Lohmander

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Palatal Surgery

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Conversion Furlow Palatoplasty and the Use of Preoperative Video Nasendoscopy

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211015008 ◽

2021 ◽

pp. 105566562110150

Author(s):

Alison Kaye ◽

Meghan Tracy ◽

Janelle Noel-MacDonnell ◽

Kathryn Dent

Keyword(s):

Velopharyngeal Insufficiency ◽

Secondary Surgery ◽

Time To Surgery ◽

Number Of Children ◽

Straight Line ◽

Improved Outcomes ◽

Additional Surgery ◽

Significant Difference ◽

Palatal Surgery ◽

Line Repair

Objective: To assess outcomes after conversion Furlow palatoplasty with and without routine preoperative flexible fiberoptic video nasendoscopy (FFVN). Design: Retrospective cohort study. Setting: Tertiary Children’s Hospital. Patients: Greater than 3 years of age with cleft palate and velopharyngeal insufficiency (VPI) after straight-line palatoplasty requiring secondary surgery performed with a Furlow palatoplasty. Main Outcome Measures: The number of children with and without routine FFVN prior to conversion Furlow palatoplasty for VPI after initial straight-line palatoplasty. Groups were compared for surgical timing, speech outcomes, and need for additional surgery after conversion Furlow palatoplasty. Results: Fifty-eight patients underwent preoperative FFVN versus 29 without. Mean age at FFVN was 73.8 (SD 34) months. Mean age for secondary palatal surgery by conversion Furlow palatoplasty was 81.5 (SD 34.8) months with FFVN versus 73.4 (SD 34.0) months without FFVN. There was a significant difference ( P < .001) for VPI diagnosis and time to surgery between the groups. Preoperative hypernasality ratings were similar between groups. Postoperatively 65.5% of FFVN and non-FFVN patients corrected to normal resonance. Only 6.9% of all patients rated moderate-severe hypernasality after surgery compared to 42.5% preoperatively. Of total, 5.7% of patients had unchanged hypernasality and only 1 patient rated worse. Seven patients ultimately required additional surgery in attempt to normalize their resonance. Conclusions: Routine preoperative FFVN does not offer any advantage for improved outcomes in children undergoing conversion Furlow palatoplasty after straight-line repair. Routine preoperative FFVN was associated with increased time to surgery after diagnosis of VPI compared to those without FFVN.

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Phonetic and Phonologic Skills of Two-Year-Olds with Cleft Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1992_029_0435_papsot_2.3.co_2 ◽

1992 ◽

Vol 29 (5) ◽

pp. 435-443 ◽

Cited By ~ 23

Author(s):

Kathy L. Chapman ◽

Mary A. Hardin

Keyword(s):

Cleft Palate ◽

Unstructured Play ◽

Palatal Surgery

This article examines the phonetic and phonologic skills of 2-year-olds with cleft palate. Fifteen children, 10 children with cleft palate and five noncleft children, participated in the study. The children with cleft palate all received palatal surgery after 12 months of age and after the onset of meaningful speech. All subjects were video and audiotaped while interacting with their mothers during unstructured play. At least one hundred different spontaneous word productions were phonetically transcribed and analyzed for (1) percent consonants correct, (2) phonologic processes, and (3) “compensatory” articulation patterns. A comparison between the groups indicated that although the children with cleft palate exhibited more errors overall, they were similar to their noncleft peers in their phonologic process usage with two exceptions. Additionally, few “compensatory” articulation errors were noted in the speech of these children.

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