10-year speech outcomes after two-flap palatoplasty

Objectives: The aim of our study is to provide speech outcomes for 10-year experience with two-flap palatoplasty by a single surgeon.

Material and method: A total of 494 palatoplasties were reviewed, of which 328 (66%) met the inclusion criteria. In addition to standard demographics, the incidence of VPI, palatal fistula, and revision palatoplasty was established. Speech evaluation was reviewed including nasal resonance, nasal air emission and articulation.

Results: Most of the 328 patients underwent primary palatoplasty at or before 12 months of age. The incidence of patients who developed VPI was 52(15.9%) patients. Revision palatoplasty for patients with persistent VPI was 13.1% (43/328). The results of the most recent speech evaluation demonstrated 95.7% of patients exhibited no or mild nasal resonance; 94% of patients had no or inaudible nasal emission and articulation was deemed normal or mildly impaired in 57% of patients, moderately impaired in 18% and severely impaired in 25% of patients.

Summary: Senior author has performed palatoplasty as a single surgeon in one institution over the past 2 decades. Due to inherent difficulties involved in retrospective study we reviewed available data from the second decade only. Our incidence of revision palatoplasty was relatively consistent throughout the decade at 13.1% (43/328). Last available speech evaluation revealed 95.7% of no or mild nasal resonance and 94% of no or inaudible nasal emission. Bardach’s two-flap palatoplasty has proven to be a reliable surgical technique with good speech outcomes. Regular and detailed speech analysis with multidisciplinary cleft patient care cannot be overemphasized.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on 10-year speech outcomes after two-flap palatoplasty
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