JMIR Publications

ABSTRACT

Background:

Infants with cleft palate often experience impaired speech due to abnormal velopharyngeal anatomy. Surgical repair aims to restore function, but procedure selection is typically based on intraoperative judgment rather than objective measures.

Objective:

The purpose of this study is to (1) to establish which pre-surgical anatomical variables are predictive of surgical procedure selection based on perceptual assessment of intraoperative tension for palate repair, and (2) to determine which post-surgical anatomical features are associated with the greatest diversity in oral stop consonant production at 18 months in children with repaired cleft palate.

Methods:

Thirty infants with unrepaired cleft palate will undergo MRI approximately 10-12 months, prior to repair, and again at 18 months. Home-based speech recordings will also be collected at both timepoints. Aim I will evaluate whether pre-surgical anatomy predicts surgical procedure selection. Aim II will examine whether post-surgical anatomy is associated with the diversity of oral stop consonant production. MRI and speech data will be analyzed using validated protocols, with logistic regression and ANCOVA applied to assess relationships among anatomy, surgery, and speech outcomes.

Results:

This project was funded in August 2024. Data collection began in April 2025. At the time of submission, 8 participants had been enrolled, and data analysis had not begun. Results are anticipated in 2027.

Conclusions:

This study will use non-sedated MRI to investigate how velopharyngeal anatomy influences surgical decision-making and early speech outcomes. Such knowledge may be useful for pre-surgical planning and early monitoring of post-surgical speech outcomes in children with cleft palate.