Timing Of Palatal Surgery Of Cleft Palate Patients And Speech Outcome

OBJECTIVE In order to understanding the effect of different operation time on the speech and palatopharyngeal closure(VPC) function of patients with palate cleft, we evaluate the articulation,hypernasality and palatopharyngeal closure function of earlier and late 18 monthes old patients underwented palatorrhaphy, through directly speech evaluation and blowing and fog experiment. In addition, we estimate the effect of earlier period palatorrhaphy on the speech functionand palatopharyngeal closure function of patient with palate cleft.METHODS Divide the sample fit the internalize standard into 3 groups:earlier period palatorrhaphy patients(A), postpone palatorrhaphy patients(B) and unimpaired child. Then, 2 phonetics physician use the speech measureing scale to evaluate the articulation and hypernasality of all of the children in the 3 groups,respectivly. Using interclass variance analysis to find the effect of different operation time on the articulation and hypernasality of patients with palate cleft.The patients in group A and B were underwented blowing and fog experiment by 2 salty physician. In the blowing experiment, all of the patinents were asked to blow at least 5 times , record the time length of blowing, then get the average of 5 times. Determine the farthest distance of the fog to the center of the circle, when the patients pronounced"P", also do it 5times and get the average. Using T-test to analysis the result.RESULTS 1. Speech intelligibility : the patients in group A were 78% in lowest, 94% in highest and 88.2% on average; In group B, the result were 36%,90% and 64.1%; In group C, the result were 86%,96% and 91.4%. Using the analysis of variance we can see that there was significant deviation between group A and group B, group B and group C(p<0.05). 2. Hypernasality: In group A, there were 3 patients without hypernasality , 11patients with hypernasality lightly, 3 patients were midrage and none was severe. In group B, there was 0 patient without hypernasality, 1 patient with hypernasality lightly, 7 patients were midrage and 11patients were severe. There was significant deviation between group A and group B(p<0.05). 3. Fog mirror experiment show that in group A, the farest distance was 2.4cm, the shortest was 0.8cm, and the average was 1.5cm; In group B, the result were: 5.2cm,2.8cm and 4cm. We found that there was significant deviation between the two groups by using the T-test to analysis (p<0.05). Through the blowing experiment ,we found that in group A the longest time was 18s, the shortest was 4s, average was 13.5s; In the group B, the result were: 22s,10.2s and 15.9s. There was significant deviation between the two groups by using the T-test to analysis (p<0.05).Conclusions 18 months ahead of their cleft palate repair in patients with speech intelligibility is better than delayed surgery, While its velopharyngeal surgery is also better than delayed.