Clinical interventions and speech outcomes for individuals with submucous cleft palate

Abstract

Background This study aimed to identify the initial diagnostic characteristics and treatment status of children with submucous cleft palate (SMCP) and to examine the relationship between the timing of surgical correction and the degree of articulation and resonance improvement.Methods This retrospective study included 72 children diagnosed with SMCP between 2008 and 2016. The evaluation criteria were the age of the initial visit, total number of visits, age at the end of treatment, speech problems, resonance problems, and speech therapy.Results Children with SMCP first visited the hospital at an average age of 34.32 months, and speech problems were identified at an average age of 48.53 months. Out of 72 children, 46 underwent surgery at an average age of 49.74 months. Four of these children required secondary surgery at an average age of 83.5 months. Among the children who underwent surgery before 3 years of age, 70% exhibited articulation improvements, with mild-to-moderate hypernasality. Articulation improvements showed no statistically significant differences according to age at the time of surgery. However, children who underwent surgery before 4 years had a better hypernasality rating than those who underwent surgery after 4 years of age.Conclusions Children with SMCP tend to undergo delayed treatment because the anatomical symptoms in some children with SMCP are unclear, and surgical interventions are considered only after speech problems are clarified. Starting interventions as early as possible reduces the likelihood of receiving secondary surgery and speech therapy, while increasing expectations for positive speech function at the end.

Speech Outcomes and Velopharyngeal Function in Children Undergoing Submucous Cleft Palate Repair

“…A group of Korean researchers reported a similar value, of which 37.5% had CA before primary surgery, which decreased to 19.2% after the surgical intervention and speech therapy, but it is not clear who received it. 31 When consulting the studies cited in this review in detail highlights the work of Baek et al, 33 who reported 45% of CA; Park et al, 34 who reported 40% glottal articulation and 13% palatalized articulation, and Ten Dam et al 5 with a 56% of articulation problems. On the other hand, in this retrospective study, no information was obtained regarding the patients who received speech therapy and for how long, so future investigations should take these factors into account.…”

Submucous Cleft Palate (SMCP): Indications and Outcomes of Radical Muscle Dissection Palatoplasty in Children Under 4 Years of Age

“…Swanson et al 18 assessed the timing of SMCP repair by Furlow palatoplasty, concluding that repair at or after 4 years is more likely to be associated with persistent misarticulation whereas treatment before 4 years is associated with reduced risk of borderline or incompetent speech. Jung et al 19 similarly highlight the importance of early diagnosis and intervention. They report this improves speech and reduces the likelihood of requiring secondary surgery.…”

“…They report this improves speech and reduces the likelihood of requiring secondary surgery. 19 The authors also concluded that delayed intervention is often due to delayed diagnosis; though anatomical abnormalities are identified they are unclear, causing diagnosis to rely on speech analysis later in life. Early assessment of SMCP cases by a MDT with SMCP scoring may reduce the incidence of such delays.…”

Subjective and Objective Evaluation of Speech in Adult Patients with Unrepaired Cleft Palate

“…This is consistent with the findings of preoperatively juvenile cleft palate patients. 30 32 Rhinomanometry which is considered the best modality for objective evaluation of nasal emission in cleft patients and is widely used in otorhinolaryngology in China. In the future, we will consider this instrument in the objective evaluation of nasality and nasal emission.…”