Summary
An evaluation of the results of one-stage repair of unilateral cleft lip and palate
(UCLP) performed at the Institute of Mother and Child, Warsaw, Poland, has shown that
the dentofacial outcomes are comparable with those of the best cleft centres. The
aim of this study was to assess speech development after one-stage closure of UCLP.
Twenty boys and eight girls at the mean age 9.6 years consecutively treated with one-stage
closure of the cleft at the mean age of 8.8 (range, 6–13) months were included. The
same surgeon performed palatal repair using a vomerplasty. The evaluated outcomes
included (1) perceptual speech evaluations with assessment of hypernasality, audible
nasal emissions (ANEs) and compensatory articulations, (2) evaluation of compensatory
facial grimacing, (3) clinical intraoral evaluation and (4) videonasendoscopy when
indicated. Our results demonstrated that 25 patients (89.3%) had normal nasal resonance.
Severe hypernasality and compensatory articulation disorders caused by velopharyngeal
insufficiency were assessed in one patient. In 13 patients (46.4%), oronasal fistulas
were found. Two children (7%) with larger fistulas presented with mild hypernasality.
In 11 cases (39.2%), fistula friction was heard at pronunciation of some anterior
sounds. Ten children (35.7%) demonstrated compensatory facial grimacing, mostly inconsistent
and mild, in the form of nasal valving. In conclusion, articulation development, velopharyngeal
sphincter competence and incidence of compensatory articulations in our sample are
satisfactory. However, only 54% of the present groups were rated as having entirely
normal speech because of high incidences of anterior palatal fistulas, and mild but
frequent fistula-related speech disturbances.
Keywords
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Article info
Publication history
Published online: October 05, 2011
Accepted:
September 6,
2011
Received:
July 23,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
