Outcome of Surgical Approach and Speech Therapy on Quality of Speech in Patients Suffering Cleft Palate

Abstract

Introduction: A patient suffering from cleft palate has speech problems even after undergoing surgical procedures to correct it. These problems can be improved by some modality of speech therapy. In this study we aimed to evaluate the outcome of our surgical approach and also the impact of speech therapy on quality of speech in patients who suffered from cleft palate and had undergone surgical correction in Mofid hospital since2011 to 2015. Materials and Methods: We evaluated the quality of speech in the patients suffering cleft palate, older than 3 years who had undergone surgical correction since 2011 to 2015 in our center. Parameters were evaluated in this study included hypernasality, audible nasal emission and disarticulation due to velopharyngeal insufficiency. This process was performed by our center’s speech professionals and informed consent was obtained from the patient's parents. Results: We studied 202 children, 101 males and 101 females. The first surgical procedure was done in the average age of 16 months. Among the postoperative complications, 90.1% of the patients had hypernasality and 66% of the patients had velopharyngeal insufficiency. All these patients were referred to speech therapy and it was shown that there is a significant improvement in the quality of their speech. There was no significant relationship between gender and prevalence of postoperative complications orhypernasality as one of the speech quality elements (P value: 0.34) and there was no significant difference between the age of first surgical reconstructive surgery and speech quality outcomes, but the early reconstruction had strong relation with reduction in postoperative complications and overall final result (P value: 0.043).According to Kruskal-Wallis statistical analysis, there were no significant superiority on speech quality outcome among the three mentioned different surgical methods (P value: 0.203).Also there was a significant improvement in correcting hypernasality as one of the main complications after speech therapy courses (P value:0.0087). Conclusion: In this study, supportive measures such as speech therapy have been shown to improve post-operative complications of cleft palate, such as hypernasality, nasal emission and disarticulation due to velopharyngeal insufficiency. Duration of speech therapy was also significantly effective on speech improvement.