Operative techniques in performing cleft palate repair have gradually evolved to achieve better speech ability with its main focus on palatal lengthening and accurate approximation of the velar musculature. The authors doubted whether the extent of palatal lengthening would be directly proportional to the speech outcome. Patients with incomplete cleft palates who went into surgery before 18 months of age were intended for this study. Cases with associated syndromes, mental retardation, hearing loss, or presence of postoperative complications were excluded from the analysis. Palatal length was measured by the authors’ devised method before and immediately after the cleft palate repair. Postoperative speech outcome was evaluated around 4 years by a definite pronunciation scoring system. Statistical analysis was carried out between the extent of palatal lengthening and the postoperative pronunciation score by Spearman correlation coefficient method. However, the authors could not find any significant correlation. Although the need for additional research on other variables affecting speech outcome is unequivocal, we carefully conclude that other intraoperative constituents such as accurate reapproximation of the velar musculature should be emphasized more in cleft palate repair rather than palatal lengthening itself.
From the *Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Pusan National University; and †Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Received September 6, 2012, and accepted for publication, after revision, May 22, 2013.
Conflicts of interest and sources of funding: none declared.
Reprints: Jae-Woo Lee, MD, Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Pusan National University, 1-10 Ami-Dong, Seo-Gu, Busan 602-739, Korea. E-mail: firstname.lastname@example.org.