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Speech evaluation after repair of unilateral complete cleft palate using modified 2-flap palatoplasty.
J Craniofac Surg. 2009 Jan; 20(1):111-4; discussion 115.JC

Abstract

Two-flap palatoplasty using mucoperiosteal flaps is becoming popular for wide cleft palates. We found that elevation of the cleft-side mucoperiosteal flap was sufficient to close the defect without elevation or relaxing incision in the noncleft side when performing 2-flap palatoplasty for a complete unilateral cleft palate. We have termed this modified 2-flap palatoplasty. The present study compared speech after classic and modified 2-flap palatoplasty for unilateral complete cleft palate.

METHODS

Of 31 unilateral complete cleft lip and palate patients, 16 underwent the classic 2-flap palatoplasty between September 1998 and September 2000, and 15 underwent modified 2-flap palatoplasty between November 2000 and November 2002. Postoperative speech evaluation was undertaken by a speech pathologist. Patients with functional speech problems such as hypernasality or compensatory articulation were recommended for speech therapy. In cases where speech therapy did not result in normal speech, patients underwent secondary velopharyngeal surgery and further speech therapy.

RESULTS

Fifteen of 16 patients who underwent the classic procedure were followed up, of which 5 showed hypernasality or compensatory articulation upon speech evaluation. Four of those patients required secondary velopharyngeal surgery. All 15 patients who underwent the modified procedure were followed up. Six of those patients showed hypernasality or compensatory articulation, of which 2 required secondary velopharyngeal surgery. There was no statistically significant difference between the classic and modified groups in terms of palatal fistula rate, speech, and secondary surgery rate.

CONCLUSIONS

There was no difference between the classic and modified 2-flap palatoplasty in terms of postoperative palatal fistula rate, speech, and secondary surgery rate. Because of the advantages of the modified procedure in terms of fewer incisions, these findings indicate that larger long-term studies are warranted, particularly to evaluate maxillary bone growth.

Authors+Show Affiliations

Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. kskoh@amc.seoul.krNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19165004

Citation

Koh, Kyung S., et al. "Speech Evaluation After Repair of Unilateral Complete Cleft Palate Using Modified 2-flap Palatoplasty." The Journal of Craniofacial Surgery, vol. 20, no. 1, 2009, pp. 111-4; discussion 115.
Koh KS, Kang BS, Seo DW. Speech evaluation after repair of unilateral complete cleft palate using modified 2-flap palatoplasty. J Craniofac Surg. 2009;20(1):111-4; discussion 115.
Koh, K. S., Kang, B. S., & Seo, D. W. (2009). Speech evaluation after repair of unilateral complete cleft palate using modified 2-flap palatoplasty. The Journal of Craniofacial Surgery, 20(1), 111-4; discussion 115. https://doi.org/10.1097/SCS.0b013e318195ab0a
Koh KS, Kang BS, Seo DW. Speech Evaluation After Repair of Unilateral Complete Cleft Palate Using Modified 2-flap Palatoplasty. J Craniofac Surg. 2009;20(1):111-4; discussion 115. PubMed PMID: 19165004.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Speech evaluation after repair of unilateral complete cleft palate using modified 2-flap palatoplasty. AU - Koh,Kyung S, AU - Kang,Byoung Su, AU - Seo,Dong Wan, PY - 2009/1/24/entrez PY - 2009/1/24/pubmed PY - 2009/5/8/medline SP - 111-4; discussion 115 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 20 IS - 1 N2 - UNLABELLED: Two-flap palatoplasty using mucoperiosteal flaps is becoming popular for wide cleft palates. We found that elevation of the cleft-side mucoperiosteal flap was sufficient to close the defect without elevation or relaxing incision in the noncleft side when performing 2-flap palatoplasty for a complete unilateral cleft palate. We have termed this modified 2-flap palatoplasty. The present study compared speech after classic and modified 2-flap palatoplasty for unilateral complete cleft palate. METHODS: Of 31 unilateral complete cleft lip and palate patients, 16 underwent the classic 2-flap palatoplasty between September 1998 and September 2000, and 15 underwent modified 2-flap palatoplasty between November 2000 and November 2002. Postoperative speech evaluation was undertaken by a speech pathologist. Patients with functional speech problems such as hypernasality or compensatory articulation were recommended for speech therapy. In cases where speech therapy did not result in normal speech, patients underwent secondary velopharyngeal surgery and further speech therapy. RESULTS: Fifteen of 16 patients who underwent the classic procedure were followed up, of which 5 showed hypernasality or compensatory articulation upon speech evaluation. Four of those patients required secondary velopharyngeal surgery. All 15 patients who underwent the modified procedure were followed up. Six of those patients showed hypernasality or compensatory articulation, of which 2 required secondary velopharyngeal surgery. There was no statistically significant difference between the classic and modified groups in terms of palatal fistula rate, speech, and secondary surgery rate. CONCLUSIONS: There was no difference between the classic and modified 2-flap palatoplasty in terms of postoperative palatal fistula rate, speech, and secondary surgery rate. Because of the advantages of the modified procedure in terms of fewer incisions, these findings indicate that larger long-term studies are warranted, particularly to evaluate maxillary bone growth. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/19165004/Speech_evaluation_after_repair_of_unilateral_complete_cleft_palate_using_modified_2_flap_palatoplasty_ L2 - https://doi.org/10.1097/SCS.0b013e318195ab0a DB - PRIME DP - Unbound Medicine ER -