[Language development in children with cleft palate].

Children with cleft palate often suffer from hearing and speech and language problems. Detailed knowledge about the long-term outcome of various therapeutic strategies including velopharyngoplasty or speech therapy seems mandatory to design an efficient rehabilitation plan for affected children. In this follow-up study 417 children with cleft palate (excluding isolated cleft lip) were examined in an interdisciplinary approach by maxillofacial surgeons, orthodontists, otolaryngologists, audiologists and speech and language pathologists. We found that 92% of the children had speech or language disorders. 80% of those children frequently had mild or severe conductive hearing loss, with or without clinical signs of otitis media with effusion. In 58 children (14%) with rhinolalia aperta not being improved by speech therapy for at least 1 year, velopharyngoplasty with a cranially based pharyngeal flap was performed. Language skills did not correlate with the type of cleft palate, but with the frequency and degree of hearing loss. Using this interdisciplinary approach for early detection and therapy of disorders related to cleft palate, only 49% of affected children had to undergo speech and language therapy. Based on the results of this follow-up study presented here we propose that otologic examination, such a thorough audiometric testing, and a detailed speech and language evaluation are important cornerstones in the rehabilitation management of children with cleft palate.