Speech Outcome Audit for Cleft Lip and Palate Patient Population Correlated With Veau Cleft Type, Surgical Repair Technique, and Patient Age

Abstract

Objective: The objective of this study is to determine speech outcome differences for specific palate repair techniques and correlate these data with patient age at the time of operation.

Methods: A retrospective study was conducted on a cohort of consecutive nonsyndromic patients who underwent cleft lip and/or palate repair at the authors' hospital between 2010 and 2020. Only those patients who participated in at least 4 years of follow-up accompanied by audio-video recording were included. The patient cohort was divided into 2 age groups, between 1 year and 2 years of age versus older than 2 years of age. Standardized perceptual speech evaluations and nasopharyngoscopy were performed by the authors' team to detect the presence of velopharyngeal insufficiency.

Results: A total of 481 patients were initially evaluated, and 323 of these patients met all inclusion criteria and were subsequently selected for this study. One hundred seventy-two patients (n = 172) underwent palatal surgery using the Bardach 2-flap palatoplasty technique, 47 patients (n = 47) underwent repair through the von Langenbeck palatoplasty technique, 78 patients (n = 78) underwent repair through Veau-Wardill-Killner palatoplasty technique, and 26 patients (n = 26) underwent repair through double-opposing Z-plasty palatoplasty. The rate of residual velopharyngeal insufficiency was statistically similar among all palatoplasty techniques. A comparison between these two age groups revealed that patients younger than 2 years of age showed higher speech outcome success.

Conclusion: High rates of speech success are achieved for patients younger than 2 years of age. Speech outcomes success is maximized by proper technique selection in relation to cleft type.

Keywords: Cleft; cleft palate; cleft palate repair; palatoplasty; speech; speech audit; speech outcomes.