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Speech outcome after cranial-based pharyngeal flap in children born with total cleft, cleft palate, or primary velopharyngeal insufficiency.
J Oral Maxillofac Surg. 2006 Dec; 64(12):1736-42.JO

Abstract

PURPOSE

The aim of this study was to compare the effect of a cranial-based pharyngeal flap on the speech of children born with a unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), cleft palate (CP), or primary velopharyngeal insufficiency (VPI) without cleft.

PATIENTS AND METHODS

A total of 234 children born with clefts and 22 children born with primary VPI were evaluated. Children with associated abnormalities were excluded from this study. The Borel-Maisonny classification system was used to evaluate the velar insufficiency. The cranial-based pharyngeal flap was performed using the Sanvenero-Rosselli technique.

RESULTS

Between 1984 and 2001, 74 children underwent pharyngeal flap for VPI. The mean follow-up period was 7 years. Borel-Maisonny scores after pharyngeal flap surgery were as follows: children with UCLP (n = 22), 59.1% type 1, 36.4% type 1/2, and 4.5% type 2; children with BCLP (n = 18), 44.4% type 1, 27.8% type 1/2, 16.7% type 2, and 11.1% type 2/3; children with CP (n = 17), 64.7% type 1, 23.5% type 1/2, and 11.8% type 2; children with primary VPI (n = 17), 29.4% type 1, 29.4% type 1/2, 29.4% type 2/3, and 11.8% type 3. There were significant differences in outcome among the 4 groups (P = .029; Fisher exact test).

CONCLUSIONS

The positive effect on speech of a cranial-based pharyngeal flap is greater in children born with a UCLP or CP than in those born with a BCLP. In children born with primary VPI, this operation has only a slightly positive effect on speech that shows compensatory misarticulations; in such cases, alternative surgical choices or secondary procedures may be indicated. This information should be clearly conveyed to the parents in presurgical consultation so that they know what to expect from the procedure and postoperative adjuvant therapy.

Authors+Show Affiliations

Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. anthony.debuys-roessingh@Chuv.hospvd.chNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17113439

Citation

de Buys Roessingh, Anthony Stephan, et al. "Speech Outcome After Cranial-based Pharyngeal Flap in Children Born With Total Cleft, Cleft Palate, or Primary Velopharyngeal Insufficiency." Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, vol. 64, no. 12, 2006, pp. 1736-42.
de Buys Roessingh AS, Cherpillod J, Trichet-Zbinden C, et al. Speech outcome after cranial-based pharyngeal flap in children born with total cleft, cleft palate, or primary velopharyngeal insufficiency. J Oral Maxillofac Surg. 2006;64(12):1736-42.
de Buys Roessingh, A. S., Cherpillod, J., Trichet-Zbinden, C., & Hohlfeld, J. (2006). Speech outcome after cranial-based pharyngeal flap in children born with total cleft, cleft palate, or primary velopharyngeal insufficiency. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, 64(12), 1736-42.
de Buys Roessingh AS, et al. Speech Outcome After Cranial-based Pharyngeal Flap in Children Born With Total Cleft, Cleft Palate, or Primary Velopharyngeal Insufficiency. J Oral Maxillofac Surg. 2006;64(12):1736-42. PubMed PMID: 17113439.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Speech outcome after cranial-based pharyngeal flap in children born with total cleft, cleft palate, or primary velopharyngeal insufficiency. AU - de Buys Roessingh,Anthony Stephan, AU - Cherpillod,Jacques, AU - Trichet-Zbinden,Chantal, AU - Hohlfeld,Judith, PY - 2005/02/03/received PY - 2005/07/15/revised PY - 2005/11/14/accepted PY - 2006/11/23/pubmed PY - 2007/1/31/medline PY - 2006/11/23/entrez SP - 1736 EP - 42 JF - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons JO - J Oral Maxillofac Surg VL - 64 IS - 12 N2 - PURPOSE: The aim of this study was to compare the effect of a cranial-based pharyngeal flap on the speech of children born with a unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), cleft palate (CP), or primary velopharyngeal insufficiency (VPI) without cleft. PATIENTS AND METHODS: A total of 234 children born with clefts and 22 children born with primary VPI were evaluated. Children with associated abnormalities were excluded from this study. The Borel-Maisonny classification system was used to evaluate the velar insufficiency. The cranial-based pharyngeal flap was performed using the Sanvenero-Rosselli technique. RESULTS: Between 1984 and 2001, 74 children underwent pharyngeal flap for VPI. The mean follow-up period was 7 years. Borel-Maisonny scores after pharyngeal flap surgery were as follows: children with UCLP (n = 22), 59.1% type 1, 36.4% type 1/2, and 4.5% type 2; children with BCLP (n = 18), 44.4% type 1, 27.8% type 1/2, 16.7% type 2, and 11.1% type 2/3; children with CP (n = 17), 64.7% type 1, 23.5% type 1/2, and 11.8% type 2; children with primary VPI (n = 17), 29.4% type 1, 29.4% type 1/2, 29.4% type 2/3, and 11.8% type 3. There were significant differences in outcome among the 4 groups (P = .029; Fisher exact test). CONCLUSIONS: The positive effect on speech of a cranial-based pharyngeal flap is greater in children born with a UCLP or CP than in those born with a BCLP. In children born with primary VPI, this operation has only a slightly positive effect on speech that shows compensatory misarticulations; in such cases, alternative surgical choices or secondary procedures may be indicated. This information should be clearly conveyed to the parents in presurgical consultation so that they know what to expect from the procedure and postoperative adjuvant therapy. SN - 0278-2391 UR - https://www.unboundmedicine.com/medline/citation/17113439/Speech_outcome_after_cranial_based_pharyngeal_flap_in_children_born_with_total_cleft_cleft_palate_or_primary_velopharyngeal_insufficiency_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0278-2391(06)01405-4 DB - PRIME DP - Unbound Medicine ER -