Speech results after repair of the cleft soft palate

The purpose of this study was to investigate the speech results of five different techniques of repair of only the cleft soft palate and also to assess the effect of timing of repair on speech results. A total of 184 patients (73 males, 111 females) underwent either a Dorrance repair (25 patients), a Wardill repair (41 patients), a Perko repair (19 patients), a von Langenbeck repair (79 patients), or a Furlow Z-plasty (20 patients) between 1964 and 1989. Articulation, intelligibility, and resonance were assessed by usually two but at least one speech therapist. All the children underwent videofluoroscopy. The follow-up period was from 3 to 24 years, with a mean of 9.6 years. The Furlow Z-plasty and Perko repair yielded the best speech results. There was a significant difference in speech and less velopharyngeal incompetence (Fisher's exact test, p = 0.0218) when the palate was repaired prior to 6 months of age as compared with after 6 months of age (for all the techniques except the Dorrance repair). Fistulas are uncommon after repair of only the soft palate.