Submucous cleft palate: outcomes after primary repair with repositioning of the levator muscle in 51 consecutive patients

Smyth, A.G.

doi:10.1016/j.bjoms.2016.02.034

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…Thirty-nine (92.9%) of the 42 patients who underwent surgery showed an improvement in postoperative hypernasality, which is consistent with the findings from a previous study 19 . There was no statistically significant difference in the improvements in hypernasality between the groups, but significant differences were found in the final hypernasality level.…”

Section: Discussionsupporting

confidence: 91%

“…Each child may require a different treatment process, and it is thus difficult to combine different intervention processes into a single strategy. Because treatments directly affect outcomes, it is essential to systematically identify an optimal treatment process by investigating the procedures involved, differences among the treatment processes, and other influential factors [19]. The purpose of this study was to investigate the initial diagnostic characteristics and treatment status of individuals with SMCP and to examine the relationship between the timing of surgical correction and the degree of articulation and resonance improvement.…”

Section: Clinical Interventions and Speech Outcomes For Individuals Wmentioning

confidence: 99%

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Clinical interventions and speech outcomes for individuals with submucous cleft palate

Jung

Koh

et al. 2020

Arch Plast Surg

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Clinical Interventions and Speech Outcomes For Individuals Wmentioning

confidence: 99%

Clinical interventions and speech outcomes for individuals with submucous cleft palate

Jung

Koh

et al. 2020

Arch Plast Surg

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“…Patients with overt SMCP yielded significantly higher VPC rate than those with occult SMCP after FP operation (Table 4). This observation was in accordance with studies by Sommerlad et al 12 and Smyth, 54 in which SMCP with less severe abnormality demonstrated less satisfactory outcome after intravelar veloplasty. There is the possibility that patients with SMCP with mild velum structural deformity often develop VPI in concert with abnormalities outside of the velum that cannot be corrected by palatoplasty.…”

Section: Discussionsupporting

confidence: 92%

“…6,30,52 Answers to these questions are critical to the risk-to-benefit evaluation of SMCP management algorithm. 53,54…”

Section: Discussionmentioning

confidence: 99%

“…6,30,52 Answers to these questions are critical to the risk-to-benefit evaluation of SMCP management algorithm. 53,54 Although various pharyngoplasty, palatoplasty, and combined techniques have been proposed, no consensus exists on the optimal surgical technique for SMCP correction. 7,18,19 Because the essential abnormality of SMCP is muscle diastasis within the velum, palate-based reconstruction, including pushback palatoplasty, intravelar veloplasty, and Furlow double-opposing Z-plasty, is the first-line technique in most cleft centers.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors for Speech Outcome among Patients with Submucous Cleft Palate Managed by Furlow Palatoplasty or Posterior Pharyngeal flap

Zhang

Shi

Zheng

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Submucous cleft palate (SMCP) is a particular subtype of cleft deformity for which the optimal surgical timing and technique are still under debate. This study aimed to identify potential prognostic factors for the speech outcome of patients with SMCP and provide evidence for further management strategy optimization. Methods: The authors reviewed patients with nonsyndromic SMCP who received either Furlow palatoplasty (FP) or posterior pharyngeal flap (PPF) between 2008 and 2021 in a tertiary hospital–based cleft center. Both univariate and multivariate logistic regression models were used to screen preoperative variables, including cleft type (overt or occult), age at surgery, mobility of velum and pharyngeal wall, velopharyngeal closure ratio, and pattern. The receiver operating characteristic curve was used to determine the cutoff value of the significant predictors for subgroup comparison. Results: A total of 131 patients were enrolled, with 92 receiving FP and 39 receiving PPF. Age at operation and cleft type were identified as having significant effects on FP outcome. Patients operated on before 9.5 years of age had a significantly higher velopharyngeal competence (VPC) rate than those operated on after that age. The speech outcome among patients with occult SMCP was significantly worse than that of patients with overt SMCP after FP treatment. No preoperative variable was found to be correlated with PPF outcome. PPF yielded a higher VPC rate than did FP among patients operated on after 9.5 years of age. Conclusions: The prognosis of patients with SMCP treated with FP is sensitive to age at surgery and cleft type. PPF may be considered for older patients in settings with limited access to multiple surgical procedures, especially when occult SMCP is diagnosed. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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Submuköse Gaumenspalte und kongenital kurzes Velum: Effekte der operativen Intervention

Brosch

Nunner

Haase

et al. 2018

HNO

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Submucous cleft palate: outcomes after primary repair with repositioning of the levator muscle in 51 consecutive patients

Cited by 8 publications

References 20 publications

Clinical interventions and speech outcomes for individuals with submucous cleft palate

Clinical interventions and speech outcomes for individuals with submucous cleft palate

Prognostic Factors for Speech Outcome among Patients with Submucous Cleft Palate Managed by Furlow Palatoplasty or Posterior Pharyngeal flap

Submuköse Gaumenspalte und kongenital kurzes Velum: Effekte der operativen Intervention

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