Palatal Plate for Covering Hard Palate Cleft after Veloplasty in Two-stage Cleft Palate Surgery

Abstract

We devised a palatal plate as an obtulator to cover the remaining cleft on the hard palate after primary veloplasty was performed on 10 children, between 18 and 24 months of age, with complete cleft lip and palate. The plate was held in position by resin between the teeth on the alveolar cleft. The purpose of this study was to evaluate the effect of the palatal plate on maxillary and speech development at 4 years of age.
The results were as follow s;
1. All children could easily wear the plate. The plate was first placed at the time of 2.1 years old on the average.
2. The in ter-maxillary occlusal relation was compared between the time of initially placing the plate and the age of 4. The intermaxillary occlusal relation between the upper and lower first incisal teeth was the same at 4 years of age in all cases. The relation between the upper and lower first deciduous molar teeth had not changed during the period either. These indicated that the palatal would not disturb maxillary developmant during the period.
3. The velopharyngeal function, at 4 years of age, was f ound normal in 80% and border in 20%, whereas the misarticulations were palatalized articulation in 50 %, lateral articulation in 40 %, and glottal stop in 30 %. Tentative removal of the palatal plate at 4 years of age definitely caused nasality, pharyngeal fricative, and glottal stop in three cases.
4. Therefore, the palatal plate, which h ad been placed after primary veloplasty, affected speech development without disturbing the maxillary growth in the chidren treated with two-stage palatal closure.