Assessment of speech development in children after uranoplasty
Authors:   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Mamedov Ad.A. , Ivoilov A.Yu. ,   G.N.Speransky City Children’s Hospital No 9 Moscow Healthcare Department, Moscow, Russian Federation,   L.I.Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Healthcare Department, Moscow, Russian Federation,   N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation, Goncharova O.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Obukhova N.V. ,   Ural State Pedagogical University, Yekaterinburg, Russian Federation, Stebeleva Yu.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Yanovsky V.V. ,   G.N.Speransky City Children’s Hospital No 9 Moscow Healthcare Department, Moscow, Russian Federation,   L.I.Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Healthcare Department, Moscow, Russian Federation,   N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation, Parshikova S.A. ,   G.N.Speransky City Children’s Hospital No 9 Moscow Healthcare Department, Moscow, Russian Federation
Published: July 2022

When attempting to determine the optimal age for uranoplasty, researchers focused on studying the pre-speech period of development, which is infancy. They believe that this period is crucial for speech development; therefore, any deficit and pathological sound production can have a negative impact. Thus, the prevention of pathological sound production is one of the main tasks of early surgery. Objective. To analyze speech development in children with cleft palate who had undergone surgeries before the age of 1 year and after it and to evaluate the effect of early uranoplasty on the speech development. Patients and methods. This study included 20 children aged between 17 months and 3.5 years. All of them had been earlier operated on for cleft palate using the method of Ad.A. Mamedov (1995). Phonetic skills were assessed postoperatively using the method of N.V. Obukhova. Ten patients underwent endoscopic examination of the palatopharyngeal ring using the method of Ad.A.Mammadov (1986). Results. The mean score reflecting phonetic skills in children with partial cleft palate operated on before the age of 6 months was 10 (satisfactory result). In children with complete cleft palate operated on at the age of 6–12 months, this score was 5.8 (near to good result). Children with complete cleft palate operated on after the age of 12 months had the phonetic skill score of 15.3 (bad result). This suggests that early uranoplasty (before the age of 12 months) ensures better speech development. Normal closure of the palatopharyngeal ring (0–20%) after uranoplasty was achieved in 80% of patients, whereas 20% of patients developed grade I palatopharyngeal insufficiency (21–40%) and were recommended to have a course with a speech therapist. Children with a more severe palatopharyngeal insufficiency (≥ 40%) should undergo repeated uranoplasty. Conclusion. We found that children with partial or complete cleft palate who had early surgeries (at the age of 0–12 months) demonstrated optimal results and better phonetic skills. Children operated on after the age of 12 months had worse results, which is associated with a formed speech stereotype at the time of intervention and the need for retraining. We believe that the repair of the partial and complete cleft palate should be performed at the age of 0–6 months and 6–12 months, respectively. Key words: cleft palate, uranoplasty, endoscopic examination, palatopharyngeal ring