Evaluation of speech after completed late closure of the hard palate

Speech was analyzed about 1 year postoperatively in 30 patients with cleft lip and palate who were the first ones to undergo late closure of the hard palate in Gothenburg, Sweden. Fourteen had bilateral and 16 had unilateral clefts. Soft palate closure had been performed at the mean age of 8 months, and the hard palate was closed at the mean age of 8 years with a range of 7-11 years. Imitated and spontaneous speech was analyzed at an average of 15 months after palatal repair. Six percent had moderate to severe hypernasal speech and 23% had retraction of dental consonants. No glottal articulation was found. Hoarseness and deviant s articulation were frequent. For 6 of the patients the same speech analysis was also made 1-3 months postoperatively. At this time there was no change in the speech of these 6 children compared with preoperative speech. Thus, the closure of the palate did not improve the speech directly. The improvement of the speech seems to be a gradual process.