Surgical and speech results following palatopharyngoplasty operations in Denmark 1959-1977

This study analysed surgical results from 600 palatopharyngoplasties (PPP), performed from 1959-77 by Dr. Poul Fogh-Andersen, Copenhagen, and the speech results in 140 of these cases. There were 205 cases of cleft lip and palate (CLP), 133 of cleft palate (CP), 104 of submucous cleft palate (SMCP), 138 of velopharyngeal insufficiency (VPI), and 20 cases of velar paresis. At surgery 62% were younger than ten years, and 5% were older than 30 years. Speech results were evaluated from pre- and postoperative tape recordings. Normal nasal resonance was obtained in 74%, improvement to mild symptoms in 24%. Submucous cleft palate cases had the highest rate of normalization, VPI cases the lowest. The cases with severest hypernasality had the lowest normalization rate. Age and operative procedure were of minor importance in relation to speech results, but surgical complications were fewer in subjects younger than ten years. Postoperative speech therapy was given to 38%, predominantly to subjects with compensatory voice and articulation problems.