[Late phoniatric results of treatment of patients with cleft palate operated on by one surgeon]

Abstract

Introduction: The aim of the study was the assessment of the late speech results the cleft palate patients. MATERIAL AND METHODIC. From January 1987 to December 1996 the first author performed 268 cleft palate surgeries. Of this number, 190 were complete unilateral and bilateral clefts, while 78 were operations of isolated soft palate. All the patients were consulted by a phoniatrist and a plastic surgeon. Among others, articulation, nasality, speech intelligibility were evaluated and nasometirc investigations were performed. The follow up examination involved 133 patients, 56 females and 77 males aged from 9 to 19 years (mean at the age of 13)--61 patients with unilateral cleft lip, alveolar process and palate (UCLP), 30 with bilateral clefts (BCLP) and 42 with isolated soft palate clefts (ICP). All the patients were operated on between 20 and 36 months of age (mean at 28 months). Two patients (1.5%) developed dehiscence of the wound on the palate and further two (1.5%) developed fistulae localized behind the alveolar process at a later time. All children with clefts were operated on by classical methods with the use of mucoperiosteal flaps for complete clefts according to Veauís method and soft palate clefts--Kilner-Wardill's method.

Results: Very good and good results of treatment were observed in 92% of cases. Poor outcome of treatment--excessive nasality or poor speech quality was observed in 11 patients (8%). A similar evaluation of the outcome of treatment was obtained on the basis of questionnaires sent to patients.

Conclusions: It seems that good speech quality can be achieved despite relatively late palate repair using Veau and Kilner-Wardill methods.