Abstract
The purpose of this study was to clarify the relationship between preoperative posterior cleft width and postoperative speech outcomes among patients with unilateral cleft lip and palate. The subjects were 29 patients with unilateral cleft lip and palate who visited the Department of Oral-Maxillofacial Surgery and Orthodontics at the University of Tokyo Hospital between 2004 and 2014. Relationships between preoperative posterior cleft width and postoperative speech function （articulation and velopharyngeal closure function） were examined.
Cleft width was measured on maxillary alveolar models before palatoplasty using sliding calipers. Mean preoperative posterior cleft width was 10mm （median, 9.9mm）. The patients were divided into two groups according to cleft width: a ＜10-mm group and a ≥10-mm group. Palatal articulation was found in patients with 6mm, 8mm, 10mm, 11mm and 13mm cleft widths, and appeared regardless of cleft width. Glottal stop articulation was found in patients with 12mm, 13mm and 16mm cleft width, showing a significant difference between groups. Nasopharyngeal closure function was good in 92％ and insufficient in 8％ of the ＜10-mm group, compared to good in 75％ and insufficient in 25％ of the ≥10-mm group. These results indicated that wide clefts tended to produce nasopharyngeal insufficiency and glottal stop articulation. These results indicate that preoperative cleft width is relevant to postoperative speech function in patients with unilateral cleft lip and palate, and that preoperative cleft width is one predictor of postoperative speech function.
