{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T06:58:26Z","timestamp":1773471506176,"version":"3.50.1"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["12ZO323N"],"award-info":[{"award-number":["12ZO323N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Adults presenting with unrepaired cleft palate are not a rare occurrence in middle\u2010income countries. However, many surgeons are hesitant to operate on these individuals because of the challenges in repairing the wide adult cleft palate, as well as concerns regarding any improvement in speech in older patients. Unfortunately, the literature on the effect of delayed palatal closure is scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the effect of delayed palatal closure on speech and self\u2010reported satisfaction in Filipino adults born with a cleft palate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>A total of 17 adults (mean age = 23.31 years) who underwent delayed palatal closure in the Philippines (a middle\u2010income country) using a three\u2010step surgical procedure (palatal repair, buccinator flaps and suspension pharyngeal flap) were included in this study. Pre\u2010 and post\u2010operative speech assessments were conducted. Nasalance values and the absence or presence of velopharyngeal insufficiency (VPI) were determined using the nasometer and videofluoroscopic assessments, respectively. A self\u2010report questionnaire was administered to evaluate satisfaction with the procedure and their speech.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>Statistically significant improvements in speech understandability and speech acceptability were observed after delayed palatal closure. With regard to resonance and nasal airflow, the presence of hypernasality and nasal emission significantly decreased post\u2010surgery. Videofluoroscopic data showed improved velopharyngeal closure following delayed palatal closure. Participants reported that their speech was significantly more intelligible in different contexts. No differences in articulation were observed before and after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>Considering the positive speech outcomes in terms of speech understandability, speech acceptability, hypernasality, nasal emission, velopharyngeal closure and self\u2010reported satisfaction, it is worthwhile to operate on adults with unrepaired palatal clefts. Post\u2010operative speech therapy to improve articulation remains necessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>WHAT THIS PAPER ADDS<\/jats:title><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Adults presenting with unrepaired cleft palate are not a rare occurrence in middle\u2010income countries. However, many surgeons are hesitant to operate on these individuals because of challenges in repairing the wide adult cleft palate as well as concerns regarding any improvement in speech in older patients.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to the existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>This study investigated the effect of delayed palatal closure on speech and self\u2010reported satisfaction in Filipino adults born with a cleft palate. We described the use of a unique three\u2010step surgical procedure including palatal repair, buccinator flaps and suspension pharyngeal flap. Significant improvements in speech understandability and speech acceptability were observed after delayed palatal closure using this three\u2010step surgical sequence. The presence of hypernasality and nasal emission significantly decreased post\u2010surgery and improved velopharyngeal functioning was observed.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>It is worthwhile to operate on adults with unrepaired palatal clefts considering the positive speech outcomes in terms of speech understandability, speech acceptability, hypernasality, nasal emission, velopharyngeal functioning and self\u2010reported satisfaction. Post\u2010operative speech therapy to improve articulation remains necessary.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.13146","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T09:24:13Z","timestamp":1734081853000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Does speech improve after delayed palatal closure in Filipino adults? Effects of combined palatal repair, buccinator flaps and suspension pharyngeal flap"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7593-8595","authenticated-orcid":false,"given":"Cassandra","family":"Alighieri","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University  Gent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Hodges","sequence":"additional","affiliation":[{"name":"Tebow Cure Hospital  Davao City Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3558-6577","authenticated-orcid":false,"given":"Jolien","family":"Verbeke","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Centre of Speech and Language Sciences Ghent University  Gent 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