Functional results of patients with cleft palate between 1993 and 2006 in Moravia II – Speech development
Authors:
Z. Dvořák 1,2; M. Pešlová 3
Authors place of work:
Lékařská fakulta Masarykovy Univerzity, Brno
1; Klinika plastické a estetické chirurgie FN U sv. Anny, Brno
2; Foniatrická a ORL ambulance, Brno-Černá Pole
3
Published in the journal:
Čes-slov Pediat 2019; 74 (6): 328-337.
Category:
Original Papers
Summary
Objective: To evaluate the results of palatal reconstruction in children with cleft palate based on the therapeutic results of the multidisciplinary team of the Cleft center at the Department of Plastic and Aesthetic Surgery of St. Anna’s Faculty Hospital in Brno (KPECH) focusing on the results of phoniatric controls.
Method: The basic set consisted of 919 patients operated from January 1, 1993 to December 31, 2006 at KPECH. Results of phoniatric controls were detected in 628 patients, 82 children were excluded from the study for an associated syndrome or a psychomotoric retardation. The resulting group consisted of 546 children. The results of speech development according to Brohm and the presence of hypernasality in 3rd, 4th, 5th and 6th years of life of the child were compared, based on the type of defect, gender and type of the surgical cleft palate reconstruction techniques used.
Results: The speech development is least altered in cleft lip, then cleft palate, and most altered in cleft lip and palate without a great difference between the unilateral and bilateral form. There is no more significant variation in the speach development and presence of hypernasality related to gender. When comparing surgical methods, children with cleft of soft palate operated by Furlow technique showed statistically significantly better speech development at 3 and 5 years of age than the children operated by two-flap palatoplasty with intravelar veloplasty (IVV). When comparing the two-flap palatoplasty with IVV or without IVV, there was a significant difference in 6-year-old patient with cleft palate and 4-year-old children with cleft lip and palate in favor of the intravelar veloplasty.
Conclusion: The best therapeutic results achieve the Furlow's palatoplasty, both in terms of speech development and hypernasality outcomes in patients with the isolated cleft palate. The two-flap palatal reconstruction with the intravelular veloplasty is indicated for the cleft lip and palate, at the price of a higher percentage of perforations and palatal scaring because it has better speech results and a lower presence of hypernasality than the two-flap palatoplasty without IVV.
Keywords:
cleft lip – cleft palate – orofacial cleft – velofaryngeal insufficiency – speech disorders
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
2019 Číslo 6
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