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The Association Between Age at Palatoplasty and Speech and Language Outcomes in Children With Cleft Palate: An
Amber D Shaffer1, Matthew D Ford2, Joseph E Losee3
1Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, PA, USA.
Insights
Late palatoplasty may lead to speech and language delays in children with cleft palate. Early or standard timing is associated with better outcomes, highlighting the importance of surgical timing for child development.
Area of Science:
- Pediatric Surgery
- Speech-Language Pathology
- Craniofacial Anomalies
Background:
- Cleft palate repair (palatoplasty) timing is crucial for speech and language development.
- Variations in surgical timing may impact long-term outcomes in children with cleft palate.
Purpose of the Study:
- To investigate the association between the timing of palatoplasty (early, standard, or late) and speech and language outcomes in children with cleft palate.
- To identify potential risks associated with delayed palatoplasty.
Main Methods:
- Retrospective case series analysis of 232 children with cleft palate ± cleft lip treated at a tertiary care children's hospital.
- Children were categorized into early (<11 months), standard (11-13 months), or late (>13 months) palatoplasty groups.
- Speech and language outcomes were assessed at 20 months and 5 years of age.
Main Results:
- Late palatoplasty was significantly associated with increased odds of speech/language delays and speech therapy at 20 months.
- Children undergoing late palatoplasty also showed increased odds of language delays at 5 years compared to early or standard groups.
- No significant association was found between palatoplasty timing and speech sound disorders, velopharyngeal incompetence, or hearing loss.
Conclusions:
- Delayed palatoplasty may be linked to both short-term and long-term speech and language developmental delays.
- Further research with standardized protocols is needed to confirm the impact of palatoplasty timing on speech and language development.
Objective:
To determine whether timing of palatoplasty (early, standard, or late) is associated with speech and language outcomes in children with cleft palate.
Design:
Retrospective case series.
Setting:
Tertiary care children's hospital.
Participants:
Records from 733 children born between 2005 and 2015 and treated at the Cleft Craniofacial Clinic of a tertiary children's hospital were retrospectively reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, syndromes, staged palatoplasty, and introduction to clinic after 12 months of age. Data from 232 children with cleft palate ± cleft lip were analyzed.
Interventions:
Palatoplasty.
Main Outcome Measures:
Speech/language delays and disorders at 20 months and 5 years of age based on formal hospital or community-based testing or screening evaluation in the Cleft Craniofacial Clinic; additional speech surgery.
Results:
Median age at palatoplasty was 12.6 months (range: 8.8-21.9 months). Age at palatoplasty was classified as early (<11 months, n = 28), standard (11-13 months, n = 158), or late (>13 months, n = 46). Late palatoplasty was associated with increased odds of speech/language delays and speech therapy at 20 months, and language delays at 5 years, compared with standard or early palatoplasty (P < .05 for all comparisons). However, speech sound production disorders, velopharyngeal incompetence, tube replacement, and hearing loss were not significantly associated with age at palatoplasty.
Conclusions:
Late palatoplasty may be associated with short- and long-term delays in speech/language development. Future studies with standardized surgical technique/timing and outcome measures are required to more definitively describe the impact of age at palatoplasty on speech/language development.
