Surgical impact and speech outcome at 2.5 years after one- or two-stage cleft palate closure

Randag, A. C., Dreise, M. M. & Ruettermann, M., Nov-2014, In : International Journal of Pediatric Otorhinolaryngology. 78, 11, p. 1903-1907 5 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • Anna C. Randag
  • Marieke M. Dreise
  • Mike Ruettermann

Objective: In the ongoing discussion about timing of palate closure, it is said that early closure is favorable for speech development, but can interfere with maxillary growth. On the other hand, beneficial results on both after one-stage palate closure have also been presented. The assumption that one-stage palate closure leads to less surgical impact on the child probably contributed to the choice for this procedure in most cleft centers. However, no previous research has verified this assumption. The aim of the present study is to compare surgical impact and speech outcome at 2.5 years of age between children who underwent either one- or early two-stage palate closure.

Methods: Patients underwent either one-stage palate closure between 2007 and 2010 at a median age of 10.8 months (group 1, n = 24) or early two-stage. closure before 2007 at median ages of 10.4 and 18.2 months, respectively (group 2, n = 24). Surgical impact was compared between the two groups by means of duration of surgery, length of hospital stay and number of post-operative complications. Speech outcome was compared by means of resonance problems, nasal air emission, articulation and intelligibility, all assessed at a median age of 2.5 years.

Results: The one-stage closure group showed significantly shorter duration of surgery and length of hospital stay (p <0.001 and p = 0.001, respectively) and significantly better articulation (p = 0.029) than the early two-stage closure group.

Conclusion: One-stage palate closure is preferable over early two-stage palate closure with regard to surgical impact and speech development. More extensive, prospective studies, in which maxillary growth is taken into account, should be conducted. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)1903-1907
Number of pages5
JournalInternational Journal of Pediatric Otorhinolaryngology
Issue number11
Publication statusPublished - Nov-2014


  • Cleft palate, One-stage palate closure, Two-stage palate closure, Speech outcome, Surgical impact, ONE-STAGE, PRIMARY VELOPLASTY, MAXILLARY GROWTH, REPAIR, PALATOPLASTY, LIP

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