Development of postoperative velopharyngeal function in patients with cleft palate

Area of Science:

• Plastic Surgery
• Speech-Language Pathology
• Pediatric Medicine

Background:

• Cleft palate often leads to velopharyngeal insufficiency (VPI), impacting speech.
• Primary palatoplasty is the standard surgical intervention for cleft palate.
• Understanding VPF development post-surgery is crucial for patient outcomes.

Purpose of the Study:

• To analyze the evolution of velopharyngeal function (VPF) after primary palatoplasty.
• To identify factors influencing VPF development and diagnosis consistency.

Main Methods:

• Retrospective analysis of 188 patients with cleft palate (CP ± L) undergoing palatoplasty.
• Postoperative VPF assessment at two time points (T1, T2) classifying VPF as normal, mild VPI, or moderate/severe VPI.
• Evaluation of VPF consistency between T1 and T2, analyzing factors like age, follow-up duration, and speech records.

Main Results:

• VPI rates decreased significantly from 48.4% at T1 to 27.1% at T2, with normal VPF increasing from 44.7% to 68.1%.
• 73.4% of patients demonstrated consistent VPF evaluations between follow-up points.
• Younger age at operation, longer follow-up duration, and better speech scores were associated with consistent VPF.

Conclusions:

• Velopharyngeal function demonstrates significant changes and improvement over time post-palatoplasty.
• Early surgical intervention (younger age) correlates with more reliable initial VPF assessment.
• Adequate follow-up duration is essential for confirming VPF status and diagnosis.