Speech Management in Early Childhood for Cleft Patients in Two-stage Palatoplasty:

Based on Backed Articulation and Maxillary Morphology Including the Residual Cleft after the Soft Palate Surgery

Abstract

Cleft patients in the Oral and Maxillofacial Surgery Clinic of Niigata University Medical and Dental Hospital have been treated according to our two-stage palatoplasty regimen. In our surgical method, soft palate surgery is performed at 1.5 years of age, after which an interim obturator is used, then the hard palate closure surgery is delayed until 4 years of age. In our unit, whereas facial growth might be improved, speech development in early childhood might be impaired to a greater or lesser extent, which is classified into three different groups. We evaluated speech outcome and maxillary morphology including the residual cleft after the soft palate surgery on each group of 16 patients to investigate speech management in late hard palate closure. As a result, backed articulation seems to be significantly related with the posterior edge of the residual cleft after soft palate closure. In order to correctly interpret the incidence of speech deficiencies, it is essential to obtain adequate information about speech management in early childhood.