Talk the Talk: The Role of Primary Language in Velopharyngeal Insufficiency

Velopharyngeal insufficiency (VPI) may occur after primary cleft palate repair. The contributory role of language to VPI is unknown. This study seeks to determine the incidence of VPI in Spanish-speaking versus English-speaking patients after cleft palate repair and evaluate patient-reported speech outcomes. Patients from the Texas Cleft-Craniofacial Team at UTHealth who had primary cleft palate repair from 2004 to 2019 were identified and divided into primary language groups: English (EN) or Spanish (SP). A retrospective analysis of VPI incidence and a prospective patient-reported survey of speech outcomes were conducted. Of the 228 patients included in the study, 46 (20%) were SP and 182 (80%) were EN. There was no statistical difference in the Veau class or type of primary palate repair performed in SP and EN patients. There was a greater incidence of VPI in SP patients compared with EN patients (52% versus 38%, P =0.04). Average median income was significantly lower in the SP group ($55,638±$23,195) compared with the EN group ($81,278±$33,869, P <0.001). Forty patients and their parents were surveyed. SP patients CLEFT-Q trended lower than EN patients in Speech Function (58±18.19 versus 68±20.61, P =0.17) and Speech Distress (64±17.30 versus 70±18.16, P =0.43). There was a statistically significant greater incidence of VPI in Spanish-speaking patients compared with English-speaking patients. Median income was lower in the Spanish group. Further research is needed to investigate contributing factors such as sociodemographics with the goal of achieving equitable outcomes in these groups.