The Prevalence of Hypernasality After Primary Cleft Palate Surgery in Children



Davari HA¹ ; Zahedi M¹ ; Derakhshandeh F² Show Affiliations
Source: Journal of Isfahan Medical School Published:2012

Abstract

Background: Children born with cleft palate are required to undergo long and group treatments. One of these treatments is the primary repair of the cleft palate. This surgery helps speech and auditory abilities. It is however commonly associated with velopharyngeal insufficiency (VPI). The present study aimed to investigate the prevalence of VPI and to identify the effective factors in increasing and decreasing this complication. Methods: After assessing 400 medical records belonging to 3-10 year-old children with cleft palate, 165 patients were included in the study. The relationships between hypernasality and some variables, including sex, cleft size, age at the time of surgery, surgical complications, and surgical technique, were then evaluated. Findings: A total number of 165 patients (61.2% males and 38.8% females) aged 3 to 10 years were evaluated in this study. The overall prevalence of hypernasality was 70.9% and the rates were not significantly different between females and males (P = 0.57). In 21.8% of the patients the cleft extended to the soft palate and in 16.4% to the soft and hard palate. Unilateral and bilateral cleft lips were respectively observed in 40% and 18.2% of the children. A submucous cleft lip was found in 3.6% of the subjects. However, there was no significant relation between size of the cleft palate and hypernasality (P = 0.71). The prevalence of hypernasality was significantly higher in patients who received Langenbeck technique compared to those operated by other surgical techniques (P = 0.03). In addition, hypernasality was more prevalent in children who were operated at older ages (P = 0.05). Conclusion: The prevalence of hypernasality in our studied population was much higher than other centers.