Dentofacial Growth and Speech Evaluation in Repaired Cleft

Objectives: The retrospective research was carried out to evaluate dento-facial changes and speech pattern in the operated cleft lip and palate patients. The patients were operated at different ages. The aim was to conclude ideal timing of palatal repair, to give best result with minimal deformity in dento-facial anatomy and speech development.

Methods: The selected sample consisted of 167 cleft patients. The children were grouped on the type of cleft as Group A: Unilateral cleft lip and palate, Group B: Bilateral cleft lip and palate, Group C: Isolated cleft palate .According to age they were grouped - Group 1: 0-18 month, Group 2: 18-36 month, Group 3: 3-6 year , Group 4:6-10 year. Study models, lateral cephalograms & orthopantomograms were prepared. Speech evaluation for articulation, nasality and intelligence was done.

Results: Data was subjected to SPSS statistical analysis and students “t” test was used for inter group comparison. Comparison of clefts showed decreased growth potential with severity of cleft. Unilateral cleft lip and palate cleft was largest group It showed in-significant difference between 0 -18 months and >18 - 36 months of age group as compared to significant difference between 3-6 yrs vs 6 - 10 yrs group in terms of length width and height of maxilla.

After cleft repair speech was best in 0-18 months age group with 23.07 % intelligibility and 30.76% cluster reduction. In 18 -36months group 35.71% had intelligible speech and 57.14% cluster reduction was observed. 3-6 years age group had 25% intelligible speech and 50% cluster reduction. Thus repair at 3-6 year is good compromise with reasonably less maxillary dimensional changes as compared to the others.

Conclusion: Early repair proved beneficial for speech against late on radiographic analysis as well as dimensional evaluation on study casts. Dento-facial growth is however impeded because of early surgical interventions