Submucous Cleft Palate and Velopharyngeal Insufficiency: Comparison of Speech Outcomes Using Three Operative Techniques by One Surgeon

Sullivan SR, Vasudavan S, Marrinan EM, et al (Children’s Hosp, Boston, MA; State Univ of New York, Syracuse) Cleft Palate Craniofac J 48:561-570, 2011^§

Abstract

Objective

Our purpose was to compare speech outcomes among three primary procedures for symptomatic submucous cleft palate (SMCP): two-flap palatoplasty with muscular retropositioning, double-opposing Z-palatoplasty, or pharyngeal flap.

Design

Retrospective review.

Setting

Tertiary hospital.

Patients, Participants

All children with SMCP treated by the senior author between 1984 and 2008.

Interventions

One of three primary procedures: two-flap palatoplasty with muscular retropositioning, double-opposing Z-palatoplasty, or pharyngeal flap.

Main Outcome Measures

Speech outcome and need for a secondary operation were analyzed among procedures. Success was defined as normal or borderline competent velopharyngeal function. Failure was defined as persistent borderline insufficiency or velopharyngeal insufficiency with recommendation for a secondary operation.

Results

We identified 58 patients with SMCP who were treated for velopharyngeal insufficiency. We found significant differences in median age at operation among the procedures (p

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