TY - JOUR
T1 - Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate
T2 - 4. Speech outcomes in 5-year-olds - velopharyngeal competency and hypernasality
AU - Lohmander, Anette
AU - Persson, Christina
AU - Willadsen, Elisabeth
AU - Lundeborg, Inger
AU - Alaluusua, Suvi
AU - Aukner, Ragnhild
AU - Bau, Anja
AU - Boers, Maria
AU - Bowden, Melanie
AU - Davies, Julie
AU - Emborg, Berit
AU - Havstam, Christina
AU - Hayden, Christine
AU - Henningsson, Gunilla
AU - Holmefjord, Anders
AU - Hölttä, Elina
AU - Kisling-Møller, Mia
AU - Kjøll, Lillian
AU - Lundberg, Maria
AU - McAleer, Eilish
AU - Nyberg, Jill
AU - Paaso, Marjukka
AU - Pedersen, Nina Helen
AU - Rasmussen, Therese
AU - Reisæter, Sigvor
AU - Søgaard Andersen, Helene
AU - Schöps, Antje
AU - Tørdal, Inger Beate
AU - Semb, Gunvor
PY - 2017
Y1 - 2017
N2 - Background and aim: Adequate velopharyngeal function and speech are main goals in the treatment of cleft palate. The objective was to investigate if there were differences in velopharyngeal competency (VPC) and hypernasality at age 5 years in children with unilateral cleft lip and palate (UCLP) operated on with different surgical methods for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. Design: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. Speech audio and video recordings of 391 children (136 girls, 255 boys) were available and perceptually analysed. The main outcome measures were VPC and hypernasality from blinded assessments. Results: There were no statistically significant differences between the prevalences in the arms in any of the trials. VPC: Trial 1, A: 58%, B: 61%; Trial 2, A: 57%, C: 54%; Trial 3, A: 35%, D: 51%. No hypernasality: Trial 1, A: 54%, B: 44%; Trial 2, A: 47%, C: 51%; Trial 3, A: 34%, D: 49%. Conclusions: No differences were found regarding VPC and hypernasality at age 5 years after different methods for primary palatal repair. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed. Trial registration: ISRCTN29932826.
AB - Background and aim: Adequate velopharyngeal function and speech are main goals in the treatment of cleft palate. The objective was to investigate if there were differences in velopharyngeal competency (VPC) and hypernasality at age 5 years in children with unilateral cleft lip and palate (UCLP) operated on with different surgical methods for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. Design: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. Speech audio and video recordings of 391 children (136 girls, 255 boys) were available and perceptually analysed. The main outcome measures were VPC and hypernasality from blinded assessments. Results: There were no statistically significant differences between the prevalences in the arms in any of the trials. VPC: Trial 1, A: 58%, B: 61%; Trial 2, A: 57%, C: 54%; Trial 3, A: 35%, D: 51%. No hypernasality: Trial 1, A: 54%, B: 44%; Trial 2, A: 47%, C: 51%; Trial 3, A: 34%, D: 49%. Conclusions: No differences were found regarding VPC and hypernasality at age 5 years after different methods for primary palatal repair. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed. Trial registration: ISRCTN29932826.
KW - cross-linguistic
KW - intercentre study
KW - primary palatal repair
KW - Randomised clinical trial
KW - Scandcleft
KW - speech
KW - unilateral cleft lip and palate
U2 - 10.1080/2000656X.2016.1254645
DO - 10.1080/2000656X.2016.1254645
M3 - Journal article
C2 - 28218551
AN - SCOPUS:85013436474
VL - 51
SP - 27
EP - 37
JO - Journal of Plastic Surgery and Hand Surgery
JF - Journal of Plastic Surgery and Hand Surgery
SN - 2000-656X
IS - 1
ER -