Velopharyngeal changes in a consecutive series of unilateral cleft lip and palate patients between the ages of 10 and 20.

Abstract

In the UK, cleft lip and/or palate affects approximately 1 in 700 babies, making it the most common facial birth defect. Approximately 150 (22%) of these will have a complete unilateral cleft of both the lip and palate (CUCLP). The purpose of this study was to establish if a particular surgical method, known as the Sommerlad technique, had over a 10 year period, impacted the growth and movement of the soft palate. The data required for the study was obtained from a retrospective analysis of standardised lateral video-fluoroscopic images. To quantify the changes in palate morphology and function, palatal extensibility, length, thickness, pharyngeal depth and palate velocity during phonation were measured. Measurements were taken at the ages of 10 and 20 years in a consecutive series of 20 CUCLP patients that had undergone palate repair by a single surgeon using the Sommerlad technique Outcome measures were assessed using descriptive statistics and the Students t-test was used to describe any significant differences of change with age. Intraclass correlation coefficient (ICC) was incorporated into the study design in order to assess intra- and inter-observer reliability. Palatal length, thickness extensibility and palate velocity increased in all patients between the ages of 10 and 20. The extensibility ratio showed no increase. Inter and intra observer reliability ranged respectively from 0.5 to 0.87 (moderate to good) and 0.67 to 0.91 (moderate to excellent). This study reveals that the soft palate continues to grow and palatal extensibility increases between the ages of 10 and 20 when primarily reconstructed using the Sommerlad technique (Sommerlad, 2003, 2015).