Speech outcomes following Orticochea pharyngoplasty in patients with cleft and non-cleft velopharyngeal dysfunction

Following cleft palate repair, some children continue to have problems with their speech. These problems often occur because the soft palate doesn’t move well enough to stop air coming through the nose when it should all come through the mouth during speech (this is called ‘velopharyngeal dysfunction’).  For example, when saying the ‘p’ or ‘b’ sound all the air should come through the mouth.  To make this happen, the soft palate has to move and close against the back of the throat, thus stopping any air coming down the nose.

There are also children who don’t have a cleft palate but who do have the same problem with their soft palate not working as well as it should. This is called non-cleft velopharyngeal dysfunction.

An Orticochoea pharyngoplasty is an operation on the back of the throat designed to help children stop the air coming down their noses when they don’t want it to during speech.

The aim of this project is to assess how effective Orticochoea pharyngoplasty is in improving speech in children with both cleft and non-cleft velopharyngeal dysfunction. It is a retrospective review of 103 children operated on by a single surgeon between 2008 and 2021, and with a minimum of 6 months’ follow up. Speech will be assessed both before and after surgery by independent specialist listeners who are blinded as to whether the speech they are hearing is from before or after the surgery.  

The results of this study that CLEFT is funding will add high quality information about how effective the Orticochea Pharyngoplasty operation can be, and therefore help surgeons decide when and whether to use this operation. The information will be shared by presentation at meetings and by publication in cleft journals.

The research team

Ms Patricia Rorison, Project Lead