Compare the outcome of two primary surgeries techniques (von Langenbeck and Furlow double z-plasty) performed on children with cleft lip/palate to determine if one results in significantly better velopharyngeal competency for speech.

This study is conducted with patients with complete unilateral cleft lip and palate. The subjects will have their palatal clefts surgically repaired by either the von Langenbeck or the Furlow double z-plasty palatoplasty. Patients will be randomly assigned to four groups, to have with the von Langenbeck palatoplasty with intravelar veloplasty or the Furlow double opposing z-plasty palatoplasty between 9 and 12 months of age or between 15 and 18 months of age. Lip repair will be randomized to either the Spina or Millard method and will be accomplished by six months prior to palatoplasty. The major emphasis will focus on assessment of the near and long term outcomes of the palatal surgeries on velopharyngeal function for speech.

Inclusion Criteria:

• Unrepaired unilateral cleft lip and palate
• Lip repair surgery to be accomplished by 3-6 months of age
• Able to return to research site at least once a year for follow-up

Exclusion Criteria:

• Patients with concomitant conditions (ie. mental retardation, deafness)
• Patients with Simonart Band of the cleft
• Patients who could not return to research site on a yearly basis