Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Postoperative Speech Outcomes and Complications in Submucous Cleft Palate Patients

  • Park, Tae Seo (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Bae, Yong Chan (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Nam, Su Bong (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Kang, Kyung Dong (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Sung, Ji Yoon (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine)
  • Received : 2015.11.09
  • Accepted : 2016.02.18
  • Published : 2016.05.18
Download PDF
⟨ Previous Next ⟩

Abstract

Background The postoperative speech outcomes of submucous cleft palate (SMCP) surgery are known to be poorer than those of other types of cleft palate. We attempted to objectively characterize the postoperative complications and speech outcomes of the surgical treatment of SMCP through a comparison with the outcomes of incomplete cleft palate (ICP). Methods This study included 53 SMCP patients and 285 ICP patients who underwent surgical repair from 1998 to 2015. The average age of the patients at the time of surgery was $3.9{\pm}1.9years$ for the SMCP patients and $1.3{\pm}0.9years$ for the ICP patients. A retrospective analysis was performed of the complications, the frequency of subsequent surgical correction for velopharyngeal dysfunction (VPD), and speech outcomes. Results In both the SMCP and ICP patients, no cases of respiratory difficulty, bleeding, or wound disruption were noted. Delayed wound healing and fistula occurred in 18.9% and 5.7% of the SMCP patients and in 14% and 3.2% of the ICP patients, respectively. However, no statistically significant difference in either delayed wound healing or fistula occurrence was observed between the two groups. The rate of surgical correction for VPD in the SMCP group was higher than in the ICP group. In the subset of 26 SMCP patients and 62 ICP patients who underwent speech evaluation, the median speech score value was 58.8 in the SMCP group and 66 in the ICP group, which was a statistically significant difference. Conclusions SMCP and ICP were found to have similar complication rates, but SMCP had significantly worse speech outcomes.

Keywords

References

  1. Bae YC, Lee JW, Seo HJ. Modified palatoplasty method (Busan modification) for incomplete type cleft palate. J Craniofac Surg 2015;26:1203-6. https://doi.org/10.1097/SCS.0000000000001716
  2. Kim JH, Bae YC, Hwang SM, et al. simple method of speech evaluation in the Korean patient with cleft palate. J Korean Soc Plast Reconstr Surg 1999;26:858-65.
  3. Emory RE Jr, Clay RP, Bite U, et al. Fistula formation and repair after palatal closure: an institutional perspective. Plast Reconstr Surg 1997;99:1535-8. https://doi.org/10.1097/00006534-199705010-00010
  4. Ahmed MK, Maganzini AL, Marantz PR, et al. Risk of persistent palatal fistula in patients with cleft palate. JAMA Facial Plast Surg 2015;17:126-30. https://doi.org/10.1001/jamafacial.2014.1436
  5. Sullivan SR, Vasudavan S, Marrinan EM, et al. Submucous cleft palate and velopharyngeal insufficiency: comparison of speech outcomes using three operative techniques by one surgeon. Cleft Palate Craniofac J 2011;48:561-70. https://doi.org/10.1597/09-127
  6. Seagle MB, Patti CS, Williams WN, et al. Submucous cleft palate: a 10-year series. Ann Plast Surg 1999;42:142-8. https://doi.org/10.1097/00000637-199902000-00006
  7. Abyholm FE. Submucous cleft palate. Scand J Plast Reconstr Surg 1976;10:209-12. https://doi.org/10.3109/02844317609012970
  8. Kaplan EN. Soft palate repair by levator muscle reconstruction and a buccal mucosal flap. Plast Reconstr Surg 1975;56:129-36. https://doi.org/10.1097/00006534-197508000-00002
  9. Dorf DS, Curtin JW. Early cleft palate repair and speech outcome. Plast Reconstr Surg 1982;70:74-81. https://doi.org/10.1097/00006534-198207000-00015
  10. Pensler JM, Bauer BS. Levator repositioning and palatal lengthening for submucous clefts. Plast Reconstr Surg 1988;82: 765-9. https://doi.org/10.1097/00006534-198811000-00006
  11. Chung JH, Lee SH, Park BY, et al. Study of cranial base structure and velopharyngeal movement in patients with submucous cleft palate using velopharyngogram. J Korean Soc Plast Reconstr Surg 1998;25:1328-37.
  12. McWilliams BJ. Submucous clefts of the palate: how likely are they to be symptomatic? Cleft Palate Craniofac J 1991; 28:247-9. https://doi.org/10.1597/1545-1569(1991)028<0247:SCOTPH>2.3.CO;2
  13. Weatherley-White RC, Sakura CY Jr, Brenner LD, et al. Submucous cleft palate: its incidence, natural history, and indications for treatment. Plast Reconstr Surg 1972;49:297-304. https://doi.org/10.1097/00006534-197203000-00010
  14. Park S, Saso Y, Ito O, et al. A retrospective study of speech development in patients with submucous cleft palate treated by four operations. Scand J Plast Reconstr Surg Hand Surg 2000;34:131-6. https://doi.org/10.1080/02844310050159981

Cited by

  1. Acquired Palatal Fistula in Patients with Submucous and Incomplete Cleft Palate before Surgery vol.43, pp.6, 2016, https://doi.org/10.5999/aps.2016.43.6.582
  2. Speech Outcomes of Korean Children with Bilateral Cleft Lip and Palate Following Primary Palatal Surgery vol.23, pp.4, 2016, https://doi.org/10.12963/csd.18564
  3. Establishing cleft services in developing countries: Complications of cleft lip and palate surgery in rural areas of Indonesia vol.46, pp.6, 2016, https://doi.org/10.5999/aps.2018.00493
  4. Surgical management in submucous cleft palate patients vol.25, pp.6, 2016, https://doi.org/10.1007/s00784-020-03719-1