How Cleft Type and Width Affect the Rate of Secondary Palatal Surgery and Articulation Proficiency in 5-Year-Olds With Cleft Palate

Åsa Okhiria; Christina Persson; Monica Blom Johansson; Fatemeh Jabbari; Malin Hakelius; Daniel Nowinski

doi:10.1177/10556656251340816

How Cleft Type and Width Affect the Rate of Secondary Palatal Surgery and Articulation Proficiency in 5-Year-Olds With Cleft Palate

Cleft Palate Craniofac J. 2025 May 14:10556656251340816. doi: 10.1177/10556656251340816. Online ahead of print.

Authors

Åsa Okhiria¹, Christina Persson^{2

3}, Monica Blom Johansson⁴, Fatemeh Jabbari¹, Malin Hakelius¹, Daniel Nowinski¹

Affiliations

¹ Department of Surgical Sciences, Plastic Surgery, Uppsala University, Uppsala, Sweden.
² Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
³ Department of Otorhinolaryngology, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁴ Department of Public Health and Caring Sciences, Speech and Language Pathology, Uppsala University, Uppsala, Sweden.

PMID: 40368334
DOI: 10.1177/10556656251340816

Abstract

ObjectiveTo investigate the association of cleft type and width with the frequency of secondary palatal surgery, articulation, and velopharyngeal function (VPF).DesignA cross-sectional study.SettingA single multidisciplinary craniofacial team at a university hospital.Patients100 patients with a non-syndromic cleft lip and or soft and hard palate born between 2000 and 2015 and treated with a 2-stage palatoplasty. Twenty-one had cleft on the soft and hard palate (SHCP), 17 had bilateral cleft lip and palate (BCLP), and 62 had unilateral cleft lip and palate (UCLP).Main outcome measuresThe impact of cleft type and width on the rate of secondary palatal surgery, the percent of correct consonants (PCC), and PCC adjusted for age (PCC-A), and the composite score for velopharyngeal competence (VPC-Sum) at 5 years of age. Articulation errors were divided into cleft speech characteristics (CSCs) and developmental speech characteristics (DSCs), and the types of errors were compared between the groups.ResultsNeither cleft type nor cleft width was associated with the need for secondary palatal surgery or VPC-Sum. Cleft width but not cleft type was significantly associated with PCC and PCC-A. There were no significant differences between cleft types regarding CSCs or DSCs. The types of errors did not differ between cleft types.ConclusionsCleft width predicted PCC and PCC-A and should be included in analyses to identify factors that may impact different outcomes. Cleft type does not seem to be a reliable predictor.

Keywords: PCC; PCC-A; articulation; cleft type; cleft width; secondary surgery.