Zweizeitiger Gaumenverschluss im Alter von 24-30 Monaten: Langzeitergebnisse der Nasalanz - eine Pilotstudie

There is still a controversy regarding the timing of repair of the deformities associated with cleft lip and palate (CLP). At Hannover Medical School 417 patients underwent primary palatoplasty and veloplasty at 24-30 months of age from 1985 to 1993. This study gives a premilary report of the long-term speech and language outcome of this collective. 30 patients were randomly selected and a retrospective evaluation of data collected from 1985 to 2000 was performed summarizing receptive and expressive speech and language skills. In a prospective evaluation those probands were reexamined (mean 13 years after palatoplasty) and the nasalance was determined with NasalViewTM. The materials used were the vowels /a:/, /e:/, /i:/, /o:/, /u:/, the sentences S1 'Die Schokolade ist sehr lecker' ('This chocolate is tasty') and S2 'Nenne meine Mamma Mimmi' ('Call my mum Mimmi'), and the text passages of LT1 'Nordwind und Sonne' 'Northwind and Sun'), LT2 'Kindergeburtstag' ('A childs birthday party') and LT3 'Der große Gesang' ('A famous song'). As a control-group 20 healthy children of the same age were selected. The median age was 14 years (range from 11 to 19 years). 27 patients (90%) did not feel any handicap, while 3 patients (10%) described little impairment. The mean nasalance for the vowels, for S1 (containing no nasal consonants), for LT2 (with many nasal sounds) and for LT3 was significantally higher than the mean nasalance of the control-group. For S2 and for LT1 there were no differances to the control. The clinical implications of these results were discussed and it is suggested that an earlier closure of the palate will lead to better functional results in CLP patients. Keywords: nasalance, nasality, cleft lip and palate, velopharyngeal incompetence, velopharyngeal insufficiency