Arch Plast Surg.  2020 Nov;47(6):542-550. 10.5999/aps.2020.00612.

Clinical interventions and speech outcomes for individuals with submucous cleft palate

Affiliations
  • 1Division of Speech Pathology and Audiology, Audiology and Speech Pathology Research Institute, Hallym University, Chuncheon, Korea
  • 2Department of Plastic Surgery, Asan Medical Center, Seoul, Korea

Abstract

Background
This study aimed to identify the initial diagnostic characteristics and treatment status of children with submucous cleft palate (SMCP) and to examine the relationship between the timing of surgical correction and the degree of articulation and resonance improvement.
Methods
This retrospective study included 72 children diagnosed with SMCP between 2008 and 2016. The evaluation criteria were the age of the initial visit, total number of visits, age at the end of treatment, speech problems, resonance problems, and speech therapy.
Results
Children with SMCP first visited the hospital at an average age of 34.32 months, and speech problems were identified at an average age of 48.53 months. Out of 72 children, 46 underwent surgery at an average age of 49.74 months. Four of these children required secondary surgery at an average age of 83.5 months. Among the children who underwent surgery before 3 years of age, 70% exhibited articulation improvements, with mild-to-moderate hypernasality. Articulation improvements showed no statistically significant differences according to age at the time of surgery. However, children who underwent surgery before 4 years had a better hypernasality rating than those who underwent surgery after 4 years of age.
Conclusions
Children with SMCP tend to undergo delayed treatment because the anatomical symptoms in some children with SMCP are unclear, and surgical interventions are considered only after speech problems are clarified. Starting interventions as early as possible reduces the likelihood of receiving secondary surgery and speech therapy, while increasing expectations for positive speech function at the end.

Keyword

Submucous cleft palate; Velopharyngeal insufficiency; Clinical study; Surgical procedure; Speech disorders
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