Evaluation of Surgical Protocols for Speech Improvement in Children with Cleft Palate: A Systematic Review and Case Series

Background: This systematic review investigates how different surgical techniques influence speech outcomes in children with cleft palate, focusing on the effectiveness of key palatoplasty methods and the timing of surgery on vocal function. Methods: A thorough search of the PubMed, Scopus, and Web of Science databases was conducted for studies published between 2014 and 2024, including clinical research reporting speech results after palatal repair, with bias assessed using the ROBINS tool. Additionally, two clinical cases are presented to demonstrate the practical application of the surgical approaches. Results: Analysis of fourteen studies revealed that modified Z-plasty and V-Y procedures enhance soft palate mobility and reduce hypernasality, although they require advanced surgical skills. Early closure of the hard palate, performed within the first year of life, was linked to improved consonant articulation compared to later surgeries. No significant differences were found between single-stage and two-stage repairs, but surgeon experience emerged as a crucial factor influencing outcomes. Conclusions: Overall, both the surgical technique selected and the timing of intervention play important roles in optimizing speech development in children affected by cleft palate.