Authors: Nyberg J, Westberg LR, Neovius E, Larson O, Henningsson G
Title: Speech results after one-stage palatoplasty with or without muscle reconstruction for isolated cleft palate
Source: Cleft Palate-Craniofacial Journal 2010 47(1): 92-103
Year: 2010
Research Design: Non Randomised Controlled Trial
Rating Score: 04/10
This rating is confirmed
Eligibility specified - Y
Random allocation - N
Concealed allocation - N
Baseline comparability - N
Blind subjects - N
Blind therapists - N
Blind assessors - Y
Adequate follow-up - Y
Intention-to-treat analysis - N
Between-group comparisons - Y
Point estimates and variability - Y

Objective: To investigate speech outcome between children with isolated cleft palate undergoing palatoplasty with and without muscle reconstruction and to compare speech outcomes between cleft and noncleft children.The number of subsequent velopharyngeal flaps was compared with respect to surgical techniques and cleft extent. Design: Cross-sectional retrospective study. Participants: One hundred four children aged 4 years, 0 months to 6 years, 0 months, 33 with isolated cleft of the soft palate, 53 with isolated cleft of the hard and soft palate, and 18 noncleft children. Interventions: Two primary palate repair techniques: minimal incision technique (MIT) and minimal incision technique including muscle reconstruction (MITmr). Main Outcome Measures: Perceptual judgment of seven speech parameters assessed on a five-point scale. Results: No significant differences in speech outcomes were found between MIT and MITmr surgery groups.The number of velopharyngeal flaps was significantly lower after MITmr surgery compared to MIT surgery.The number of flaps was also significantly lower in children with cleft of the soft palate compared to children with cleft of the hard and soft palate.Children with cleft of the soft palate had significantly less glottal articulation and weak pressure consonants compared to children with cleft of the hard and soft palate. Conclusions: The MITmr surgery technique was not significantly superior to the MIT technique regarding speech outcomes related to velopharyngeal competence, but had fewer velopharyngeal flaps, which is contradictory. Until a larger sample can be studied, we will continue to use MITmr for primary palate repair. © Allen Press Publishing Service

Access: Open Access