The Speech Outcome of Long-term Follow-up after Palatoplasty

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  • 口蓋裂術後言語成績の経年的変化について

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Abstract

Purpose: We investigated long-term changes in velopharyngeal function (VPF) and speech articulation in cleft palate patients who underwent initial palatoplasty at Shizuoka Children's Hospital.<br>Subjects: Of the 329 cases who received the first operation after 1989, we studied 104 patients (52 boys, 52 girls) who were able to undergo a regular medical examination from the age of four until 16 years old. There were 18 patients with bilateral cleft lip and palate (BCLP), 43 with lateral cleft lip and palate (UCLP), and 43 with isolated cleft palate.<br>Results: For VPF, any age showed the good result that 80-90% of patients did not need active treatment. On the other hand, a decrease of good closure function was observed in all cleft types over time. As for the presence and type of articulation disorder, a significant difference was observed according to the cleft type. There were some cases in which the articulation disorder had improved without speech therapy due to orthodontic treatments and alveolar bone grafting. In the patients having permanent articulation disorders, about half of them did not want to receive speech therapy, and all these patients showed palatalized or lateralized articulation disorder.<br>Conclusion: This investigation shows that the treatment results for cleft lip and palate patients seem to be stable on the whole. However, the results fluctuate with age in individual cases, and so long-term follow-up is necessary. Therefore, a multidisciplinary team approach in the same facility is necessary to enable the patients to receive ongoing medical examinations.

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