Effect of method of cleft palate repair on the quality of speech at the age of 6 years.

Two methods of primary palatal repair were compared for the effect that they had on the speech of 6 year old children with cleft (lip and) palate. A Veau-Wardill-Kilner V to Y pushback operation was done for 43 children (group V) and the Cronin modification for 60 children (group C) between the ages of 12 and 18 months. The groups were compared with respect to the quality of speech assessed clinically by perception, by instrumental measures of nasalance, and by the number of velopharyngeal flaps required. The quality of speech was assessed in terms of perceived signs of velopharyngeal insufficiency: hypernasality, audible nasal air emissions, weakness of plosives and compensatory articulations. Hypernasality was significantly more common in group V (16/33, 48%) than in group C (11/49, 22%) (p = 0.01). The number of velopharyngeal flaps and the nasalance scores derived from most of the individual test sentences were similar in the two groups. The mean nasalance score for the whole set of test sentences was significantly higher in group V.