How Cleft Type and Width Affect the Rate of Secondary Palatal Surgery and Articulation Proficiency in 5-Year-Olds With Cleft Palate

ObjectiveTo investigate the association of cleft type and width with the frequency of secondary palatal surgery, articulation, and velopharyngeal function (VPF).DesignA cross-sectional study.SettingA single multidisciplinary craniofacial team at a university hospital.Patients100 patients with a non-syndromic cleft lip and or soft and hard palate born between 2000 and 2015 and treated with a 2-stage palatoplasty. Twenty-one had cleft on the soft and hard palate (SHCP), 17 had bilateral cleft lip and palate (BCLP), and 62 had unilateral cleft lip and palate (UCLP).Main outcome measuresThe impact of cleft type and width on the rate of secondary palatal surgery, the percent of correct consonants (PCC), and PCC adjusted for age (PCC-A), and the composite score for velopharyngeal competence (VPC-Sum) at 5 years of age. Articulation errors were divided into cleft speech characteristics (CSCs) and developmental speech characteristics (DSCs), and the types of errors were compared between the groups.ResultsNeither cleft type nor cleft width was associated with the need for secondary palatal surgery or VPC-Sum. Cleft width but not cleft type was significantly associated with PCC and PCC-A. There were no significant differences between cleft types regarding CSCs or DSCs. The types of errors did not differ between cleft types.ConclusionsCleft width predicted PCC and PCC-A and should be included in analyses to identify factors that may impact different outcomes. Cleft type does not seem to be a reliable predictor.