4 241

Cited 20 times in

Outcomes of Cleft Palatal Repair for Internationally Adopted Children

 Stephen R. Sullivan  ;  Young-Soo Jung  ;  John B. Mulliken 
 PLASTIC AND RECONSTRUCTIVE SURGERY, Vol.133(6) : 1445-1452, 2014 
Journal Title
Issue Date
Adoption* ; Age Factors ; Child ; Child, Preschool ; Cleft Palate/surgery* ; Female ; Humans ; Infant ; Male ; Oral Fistula/surgery ; Palate, Hard/surgery* ; Palate, Soft/surgery* ; Reconstructive Surgical Procedures/methods ; Reoperation/statistics & numerical data ; Speech* ; Speech Intelligibility ; Speech Therapy ; Surgical Flaps ; Treatment Outcome ; Velopharyngeal Insufficiency/etiology
BACKGROUND: Families in the United States adopted approximately 230,000 foreign-born children over the past two decades. Age at adoption and the presence of a cleft palate impact speech and language development. The authors' purpose is to document speech outcome after palatal closure in internationally adopted children. METHODS: The authors reviewed internationally adopted children with cleft lip-cleft palate or cleft palate who had two-flap palatoplasty from 1987 to 2010. Data collected included date of birth, cleft palatal type, age at palatoplasty, palatal fistula, postoperative speech assessment, and need for secondary surgery. RESULTS: The authors identified 55 children adopted with unrepaired cleft palate. Palatal types were Veau I (n = 1), II (n = 1), III (n = 37), or IV (n = 16). Median age at palatoplasty was 25.6 ± 11.8 months; palatal fistula occurred in five patients (9 percent). Speech outcome was successful in 28 patients (51 percent), whereas a secondary operation was recommended for 27 patients (49 percent). Need for a secondary operation was independent of palatal type (p = 0.6). Children who required a pharyngeal flap were significantly older at the time of palatoplasty compared with those who did not (p = 0.009). There was a significant association between increasing age at palatoplasty and need for a secondary operation (OR, 1.07; 95 percent CI, 1.01 to 1.13; p = 0.01). Pharyngeal flap significantly improved speech (p < 0.001). CONCLUSIONS: International adoption with late palatoplasty can result in disordered speech. Velopharyngeal insufficiency is associated with increasing age at palatoplasty. The authors recommend palatoplasty and speech therapy soon after adoption.
Full Text
Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
Yonsei Authors
Jung, Young Soo(정영수) ORCID logo https://orcid.org/0000-0001-5831-6508
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.