von Langenbeck or Wardill procedures for primary palatal repair in patients with isolated cleft palate - speech results

Sixty-six patients operated on for isolated cleft palate were evaluated as adults, and their speech was assessed clinically. Forty-four had undergone a von Langenbeck repair at the age of 7 months and 22 a Wardill repair at t he age of 18 months. Speech was judged subjectively by the patients themsel ves, and perceptual assessment was made by three speech pathologists. The r emaining speech problems, mainly hypernasality, were moderate or severe in 7 (16%) of the patients in the von Langenbeck group, and in 7 (32%) in the Wardill group. On the other hand, the patients in the Wardill group had few er fistulas closed, and fewer velopharyngoplasties. There were no significa nt differences between the two methods regarding speech in adulthood. The W ardill method produced significantly more scar tissue clinically, which car ries the potential risk of inhibition of facial growth. The present speech results will therefore be weighed against the outcome of maxillofacial grow th for these patients.