Comparative study of 2 palatoplasty techniques to assess speech and fistula in primary cleft palate patients.

Purpose: To assess the Quality of speech and the incidence of post operative fistula in each technique after 6 months follow up study.

Methods: This prospective study consists of 24 patients in the age group of 18 to 36 months, male 12 and female 12. All the patients were divided into two groups-Group I-12 patients for two layer closure, Group II-12 patients for three layer closure. Exclusion criteria was submucous clefts, any identified syndrome and patients with hearing loss. All the patients have undergone pre-operative speech assessment by the speech therapist. At end of 6 months, speech analysis was done based on three parameters, i.e. nasality (A), Articulation (B) and intelligibility (C).

Results: Patients with radical muscle dissection (three layer) group had statistically significant (P=0.023) improvement in nasal resonance compared to the conservative technique (two layer) in the younger age group. But there was no statistically significant difference in the articulation and the intelligibility of speech.

Conclusion: Radical dissection and palatal muscle reconstruction confers better functional results regarding nasal resonanace, especially in younger age group. Quality of speech in the elder group, patients 25-36 months old in both the technique groups was almost the same. The incidence of fistula was slightly more in the radical dissection group.