A study was done comparing how a one stage cleft repair affects a child's speech and how a two step cleft repair affects a child's speech. The study used the Muhler classification system to assess the participants' speech. The Muhler classification system assesses a person's resonance, nasal escape, compensatory articulation, facial grimace, and spontaneous speech. The classifications run from 0-3 or 4 with 0 being normal speech and 3 or 4 being severe speech problems. The results showed that a one stage repair has the best benefits for a cleft patient. It also makes a difference when the surgery is done and it seems to be most beneficial when the surgery is done between 9 and 12 months. Children who had their cleft repaired after 2 years had more severe speech problems. If a repair is delayed past 2 years the speech mechanisms have already formed so more speech problems are likely to appear. The advantages to a child have a one step repair is that there is only one hospitalization, less scaring in the palate region, better speech development, and no dissection in scarred tissue of the soft palate. There are some disadvantages though including larger wound site, increased blood loss, and airway obstruction. Not only does a one step repair done between 9-12 months benefit speech but it also benefits maxillary growth. For these reasons a one stage palate repair is preferred over a two step procedure.
Pradel, W. "One-Stage Palate Repair Improves Speech Outcome and Early Maxillary Growth in Patients with Cleft Lip and Palate". Journal of Physiology and Pharmacology. 60.8 (2009): 37-41. Jpp.krakow.pl. 7 July 2010.
Thanks for sharing with us. Most children who have their clefts repaired early enough are able to have a happy youth and social life. Cleft lip treatment in India.
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