Videoendoscopic, speech and hearing in cleft palate children after levator-palatopharyngeus surgery according to Kriens

SUMMARYIntroductionThe importance of the soft palate is greater than its dimension. Velopharyngeal muscles have diverse functions. The goal of this study was to clarify the efficacy of levator-palatopharyngeus surgery according to Kriens.Material and methodsRetrospective follow-up of 22 cleft patients operated at the Department of Oral and Maxillo-Facial and Plastic Surgery at the University of Greifswald between 1994 to 2001, within the context of primary closure of the palate. A questionnaire evaluated parents' opinion of postoperative results of treatment. Speech, videoendoscopics and hearing findings were analyzed.ResultsParents assessed success of the treatment as adequate to very good. More than a half of the patients had perfect or very usable colloquial speech. Speech findings of patients with palatal clefts (CP) were significantly better than those of patients with clefts of lip, alveolus and palate (CLAP) (p = 0.043). Velopharyngeal closure pattern with highest prevalence was the coronal closure type. Subjects with CLAP were much more likely to have poor velopharyngeal closure (VPI > 2 mm2; 58%) than those with a CP (12%). More than 75% of the patients showed normal hearing results in the audiogram.ConclusionLevator-palatopharyngeus surgery according to Kriens seems to be effective in exact reconstruction of velar muscle sling, improving velopharyngeal structure and function.