Hanai Ushio, Akamatsu Tadashi, Okawa Tomoe, Kaneko Akifumi, Watanabe Miki, Muramatsu Hiroyuki, Tsunoda Yotaro, Nemoto Hitoshi, Imagawa Kotaro
From the Department of Plastic and Reconstructive Surgery, Tokai University, Isehara, Kanagawa, Japan.
Ichikawa Orthodontic Office Shinwakai Medical Corporation, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2025 Apr 18;13(4):e6688. doi: 10.1097/GOX.0000000000006688. eCollection 2025 Apr.
Reliable early prediction of long-term speech outcomes after primary palatoplasty has not been explored. This study aimed to (1) clarify the relationship between the pattern of initial consonant production and postoperative speech outcome in patients with cleft palate (CP), and (2) investigate whether differences exist in the order pattern of initial consonant production by CP presence.
Consecutive children who underwent primary CP surgery between 2001 and 2016 at our hospital were retrospectively analyzed; 42 and 38 children were assigned to the CP and non-CP groups, respectively. The production order of the main Japanese consonants/k/,/g/,/t/, and/d/ was analyzed, and 3 groups were created: type td, where t/d precedes k/g; type kg, where k/g precedes t/d; and type same, where t/d and k/g occur simultaneously. We compared consonant patterns between groups and assessed the association between these patterns and the incidence of velopharyngeal insufficiency (VPI), abnormal articulations, and the need for additional treatment in the CP group.
At both 4 and 7 years, the likelihood of having VPI was significantly higher in type kg children than in type td children. Velar consonants did not precede alveolar consonants in the non-CP group. Significantly more type kg patients received additional treatment than type td ( < 0.001) and type same ( = 0.003) groups.
Patients with normal velopharyngeal function acquired alveolar consonants (td) before velar consonants (kd), indicating that those who first produced velar consonants were more likely to present with VPI or require additional treatment.
尚未探索腭裂一期修复术后长期语音结果的可靠早期预测方法。本研究旨在：（1）阐明腭裂（CP）患者初始辅音发音模式与术后语音结果之间的关系；（2）研究CP患者与非CP患者在初始辅音发音顺序模式上是否存在差异。
对2001年至2016年在我院接受腭裂一期手术的连续儿童进行回顾性分析；分别将42名和38名儿童纳入CP组和非CP组。分析日语主要辅音/k/、/g/、/t/和/d/的发音顺序，并分为3组：td型，即t/d在k/g之前；kg型，即k/g在t/d之前；相同型，即t/d和k/g同时出现。我们比较了各组之间的辅音模式，并评估了这些模式与CP组中腭咽闭合不全（VPI）的发生率、异常发音以及额外治疗需求之间的关联。
在4岁和7岁时，kg型儿童发生VPI的可能性显著高于td型儿童。非CP组中软腭辅音不先于齿龈辅音出现。接受额外治疗的kg型患者明显多于td型（<0.001）和相同型（=0.003）组。
腭咽功能正常的患者在软腭辅音（kd）之前获得齿龈辅音（td），这表明首先发出软腭辅音的患者更有可能出现VPI或需要额外治疗。
