Speech outcomes in isolated cleft palate: impact of cleft extent and additional malformations.

OBJECTIVE

The purpose of the study was to study the speech outcome in a series of 5-year-old children born with an isolated cleft palate and compare the speech with that of noncleft children and to study the impact of cleft extent and additional malformation on the speech outcome.

DESIGN

A cross-sectional retrospective study.

SETTING

A university hospital serving a population of 1.5 million inhabitants.

SUBJECTS

Fifty-one patients with an isolated cleft palate; 22 of these had additional malformations. Thirteen noncleft children served as a reference group.

INTERVENTIONS

A primary soft palate repair at a mean of 8 months of age and a hard palate closure at a mean age of 4 years and 2 months if the cleft extended into the hard palate.

MAIN OUTCOME MEASURES

Perceptual judgment of seven speech variables assessed on a five-point scale by three experienced speech pathologists.

RESULTS

The cleft palate group had significantly higher frequency of speech symptoms related to velopharyngeal function than the reference group. There were, however, no significant differences in speech outcome between the subgroup with a nonsyndromic cleft and the reference group. Cleft extent had a significant impact on the variable retracted oral articulation while the presence of additional malformations had a significant impact on several variables related to velopharyngeal function and articulation errors.

CONCLUSION

Children with a cleft in the soft palate only, with no additional malformations, had satisfactory speech, while children with a cleft palate accompanied by additional malformations or as a part of a syndrome should be considered to be at risk for speech problems.