[Influential factors affecting the postoperative velopharyngeal function among aged cleft palate patients]

Area of Science:

• Craniofacial surgery
• Pediatric plastic surgery
• Speech and language pathology

Background:

• Velopharyngeal function is crucial for speech intelligibility.
• Cleft palate repair aims to restore normal velopharyngeal function.
• Optimal surgical timing and techniques for older children remain debated.

Purpose of the Study:

• To identify factors influencing post-operative velopharyngeal function in cleft palate patients over two years old.
• To evaluate the effectiveness of different surgical approaches.

Main Methods:

• Retrospective analysis of 245 patients' records.
• Inclusion of clinical features: cleft ratio, operative age, and method.
• Assessment of post-operative velopharyngeal function (competence/incompetence).

Main Results:

• No significant difference in cleft or adequate ratios between velopharyngeal competence (VPC) and incompetence (VPI) groups.
• VPC rates did not significantly differ by age group or diagnosis.
• Surgical method demonstrated a significant impact on post-operative VPC rates.

Conclusions:

• Current protocols for younger children are unsuitable for those over two.
• Cleft ratio is not the primary determinant of post-operative velopharyngeal function.
• Combined Sommerlad-Levator Veli Palatini reconstruction and sphincter pharyngoplasty improves velopharyngeal function in older patients and should be considered for primary palatoplasty.