Electromyographic Activity of the Masseter and Temporal Muscles in Patients With Nonsyndromic Complete Unilateral Cleft Lip and Palate: 2-Stage Versus 1-Stage Palate Repair.

OBJECTIVE: To assess the electromyographic activity of the masseter and temporal muscles in cleft patients who underwent 1-stage palate repair versus 2-stage palate repair. METHODS: Thirty-two patients with nonsyndromic complete unilateral cleft lip and palate operated by 2 different protocols for palate repair, 1-stage (group 1, n = 16) versus 2-stage with delayed hard palate closure (group 2, n = 16) were available in the retrospective longitudinal study. Standardized electromyographic records of the masseter and anterior portion of temporal muscles were obtained with 2 repetitions during mastication and rest. RESULTS: No statistically significant (all P > 0.05) differences were observed in the electromyographic data between the groups 1 and 2. CONCLUSION: There were similar electromyographic activity of masseter and temporal muscles during mastication and at rest after 1- and 2-stage palate closure.

Bilateral buccinator myomucosal flap outcomes in nonsyndromic patients with repaired cleft palate and velopharyngeal insufficiency.

BACKGROUND: The purpose of this study was to assess speech outcomes and complication rate in nonsyndromic repaired cleft palate patients undergoing bilateral buccinator myomucosal flaps for velopharyngeal insufficiency management. METHODS: A prospective study of consecutive repaired cleft palate patients with velopharyngeal insufficiency who underwent bilateral buccinator myomucosal flaps was conducted. Three experienced evaluators performed a blinded perceptual speech evaluation (hypernasality, audible nasal emission, and intraoral pressure). Successful speech outcome was defined as normal or borderline sufficient velopharyngeal function at 15 months postoperatively. Obstructive sleep apnea screening tools were applied preoperatively and postoperatively. Complication rate was also collected. RESULTS: Fifty-three patients were included. There were 11 (21%) surgical complications, with no complete flap loss, snoring, sleep disturbance, and/or mouth breathing. All patients presented low pre- and postoperative risk for obstructive sleep apnea. At 15 months postoperatively, hypernasality (0.4 ± 0.6), audible nasal emissions (0.2 ± 0.4), and intraoral pressure (0.1 ± 0.3) were significantly (all p < 0.05) lower than preoperative measurements (hypernasality: 2.7 ± 0.5; audible nasal emissions: 2.2 ± 0.8; and intraoral pressure: 0.9 ± 0.3). Forty-five (85%) patients presented successful speech outcome. CONCLUSION: The bilateral buccinator myomucosal flap is an effective and safe surgical strategy for the management of persistent velopharyngeal insufficiency.