{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T02:40:58Z","timestamp":1778899258423,"version":"3.51.4"},"reference-count":17,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,12,4]],"date-time":"2018-12-04T00:00:00Z","timestamp":1543881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>The purpose of this study was to assess surgical outcomes of two-flap palatoplasty for management of cleft palate. Between January 2009 and January 2017, we recruited 29 nonsyndromic patients who underwent two-flap palatoplasty for cleft palate repair at the oral and maxillofacial department. Their medical records were procured, and surgical outcomes were assessed. Velopharyngeal insufficiency (VPI) was evaluated on the basis of speech assessment by a speech therapist. Speech abnormality (nasality, nasal emission, and articulation error) was assessed by a speech therapist using the GOSS-Pass test. Swallowing and regurgitation were assessed by a swallowing team. Fistula and wound dehiscence were clinically assessed by the primary investigator. Documented data were evaluated using statistical analysis. Among the study patients; 75.8 % had normal speech, 20.7 % developed VPI; 17.3% had hypernasality; 4.3% had hypernasality as well as nasal emission; 4.3% had hypernasality, nasal emission, and articulation errors; and 4.3% had articulation errors. Approximately 20% of the patients had fistulas (83.3% had oronasal fistulas and 16.7% had nasovestibular fistulas). Normal swallowing findings were noted in 93% of the patients. There were statistically significant relationships between age-repair and VPI (r=0.450, t=0.014), age-speech (r=0.525, t=0.003), and age-fistula development (r=0.414, t=0.026). Conversely, there were no significant relationships between age and dehiscence (r=0.127, t=0.512), age and swallowing (r=0.360, t=0.055), and age and regurgitation (r=0.306, t=0.106). Two-flap palatoplasty is a reliable technique with excellent surgical and speech outcomes. Early repair is associated with better speech outcome and less incidence of VPI.<\/jats:p>","DOI":"10.4081\/cp.2018.1104","type":"journal-article","created":{"date-parts":[[2018,12,4]],"date-time":"2018-12-04T18:40:45Z","timestamp":1543948845000},"page":"1104","source":"Crossref","is-referenced-by-count":7,"title":["Surgical Outcome of Two-Flap Palatoplasty at King Fahad Medical City: A Tertiary Care Center Experience"],"prefix":"10.3390","volume":"8","author":[{"given":"Alwaleed Khalid","family":"Alammar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulsalam","family":"Aljabab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gururaj","family":"Arakeri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,12,4]]},"reference":[{"key":"ref1","first-page":"765","article-title":"Cleft lip and palate: comprehensive treatment and technique","author":"Myers","year":"2008"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.ijom.2012.01.010","article-title":"An effect comparison between Furlow double opposing Z-plasty and two-flap palatoplsty on velopharyngeal closure","volume":"41","author":"Dong","year":"2012","journal-title":"Int J Oral Maxillofac Surg"},{"key":"ref3","first-page":"313","article-title":"Head and neck embryology","author":"Sadler","year":"1990"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"S102","DOI":"10.4103\/0970-0358.57197","article-title":"Cleft palate repair and variations","volume":"42","author":"Agrawal","year":"2009","journal-title":"Indian J Plast Surg"},{"key":"ref5","article-title":"Anatomy of the facial skeleton in cleft lip and palate","author":"Latham","year":"1990"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/S1071-0949(06)80034-X","article-title":"Two-Flap palatoplasty: Bardach\u2019s technique","volume":"2","author":"Bardach","year":"1995","journal-title":"Oper Tech Plast Reconstr Surg"},{"key":"ref7","first-page":"224","article-title":"Surgical techniques in cleft lip and palate. 2nd ed","author":"Bardach","year":"1991"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1097\/00006534-199012000-00007","article-title":"Does interference with mucoperiosteum and palatal bone affect craniofacial growth? An experimental study in beagles","volume":"86","author":"Bardach","year":"1990","journal-title":"Plast Reconstr Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/01.prs.0000220875.87222.ac","article-title":"Two-flap palatoplasty: 20-year experience and evolution of surgical technique","volume":"118","author":"Salyer","year":"2006","journal-title":"Plast Reconstr Surg"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1097\/PRS.0000000000000224","article-title":"Outcomes of cleft palatal repair for internationally adopted children","volume":"133","author":"Sullivan","year":"2004","journal-title":"Plast Reconstr Surg"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1597\/06-204.1","article-title":"The Pittsburgh fistula classification system: a standardized scheme for the description of Palatal fistulas","volume":"44","author":"Smith","year":"2007","journal-title":"Cleft Palate- Craniofac J"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1097\/PRS.0b013e3181845a21","article-title":"The importance of radical intravelar veloplasty during two-flap palatoplasty","volume":"122","author":"Andrades","year":"2008","journal-title":"Plast Reconstr Surg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/j.ijporl.2009.03.027","article-title":"Cleft lip and palate treatment of 530 children over a decade in a single center","volume":"73","author":"Vlastos","year":"2009","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1097\/SCS.0b013e318192801b","article-title":"Palatoplasty outcomes in nonsyndromic patients with cleft palate: a 29-year assessment of one surgeon\u2019s experience","volume":"20","author":"Sullivan","year":"2009","journal-title":"J Craniofac Surg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"e840","DOI":"10.1097\/GOX.0000000000000837","article-title":"The influence of palatoplasty on eating function","volume":"4","author":"Fujikawa","year":"2016","journal-title":"Plast Reconstr Surg Global Open"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/00006534-198207000-00015","article-title":"Early cleft palate repair and speech outcome","volume":"70","author":"Dorf","year":"1982","journal-title":"Plast Reconstr Surg"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3109\/02844319209035186","article-title":"Correlation between the age at repair and speech outcome in patients with isolated cleft palate","volume":"26","author":"Haapanen","year":"1992","journal-title":"Scandin J Plast Reconstr Surg Hand Surg"}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.clinicsandpractice.org\/index.php\/cp\/article\/download\/1104\/937","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.clinicsandpractice.org\/index.php\/cp\/article\/download\/1104\/941","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mdpi.com\/2039-7283\/8\/4\/1104\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T06:55:21Z","timestamp":1644476121000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/8\/4\/1104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,4]]},"references-count":17,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,10]]}},"alternative-id":["cp.2018.1104"],"URL":"https:\/\/doi.org\/10.4081\/cp.2018.1104","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,4]]}}}