Objective To compare speech outcomes following primary cleft palate repair using modified Sommerlad palatoplasty (MSP) versus Sommerlad–Furlow modified palatoplasty (SFP). Design Retrospective cohort study. Setting A high-volume tertiary cleft center. Patients Patients who underwent primary cleft palate repair before 5 years of age between 2011 and 2021 were retrospectively reviewed. Participants Patients treated with MSP or SFP and with complete follow-up records were included. Participants were stratified by age at surgery as younger than 1.5 years or 1.5 years and older. Interventions Primary cleft palate repair with MSP or SFP. Main Outcome Measure(s) Postoperative speech outcomes, particularly velopharyngeal competence (VPC), and factors associated with speech performance. Results A total of 1265 patients were included, of whom 874 underwent surgery before 1.5 years of age and 391 at 1.5 years or older. In the younger group, surgical technique and cleft type were significantly associated with speech outcomes. After adjustment for baseline differences, SFP achieved a significantly higher VPC rate than MSP in patients with Veau III cleft palate (84.4% vs 73.0%, P = .027). In the older group, sex, cleft type, and surgical technique were not significantly associated with speech outcomes. Conclusions In this cohort, speech outcomes after primary palatoplasty were influenced by surgical technique and cleft type. For patients with Veau III cleft palate who underwent repair before 1.5 years of age, SFP was associated with superior speech outcomes compared with MSP.
Dou et al. (Mon,) studied this question.