Scandcleft Randomized Trials of Primary Surgery for Unilateral Cleft Lip and Palate: Speech Proficiency at 10 Years of Age

Autor/inn/en	Willadsen, E.; Jørgensen, L. D.; Alaluusua, S.; Pedersen, N. H.; Nielsen, J. B.; Hölttä, E.; Hide, Ø.; Hayden, C.; Havstam, C.; Hammarström, I. L.; Davies, J.; Boers, M.; Andersen, H. S.; Aukner, R.; Jackson Morris, D.; Nielsen, S. F.; Semb, G.; Lohmander, A.; Persson, C.
Titel	Scandcleft Randomized Trials of Primary Surgery for Unilateral Cleft Lip and Palate: Speech Proficiency at 10 Years of Age
Quelle	In: International Journal of Language & Communication Disorders, 58 (2023) 3, S.892-909 (18 Seiten) PDF als Volltext Verfügbarkeit
Zusatzinformation	ORCID (Willadsen, E.) ORCID (Jørgensen, L. D.) ORCID (Persson, C.)
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1368-2822
DOI	10.1111/1460-6984.12830
Schlagwörter	Surgery; Congenital Impairments; Speech Skills; Outcomes of Treatment; Children; Language Proficiency; Phonemes + Suchen Sie Ihr Suchwort? Chirurgie; Mündliche Leistung; Sprachfertigkeit; Child; Kind; Kinder; Language skill; Language skills; Sprachkompetenz; Fonem
Abstract	Background & Aim: To assess consonant proficiency and velopharyngeal function in 10-year-old children born with unilateral cleft lip and palate (UCLP) within the Scandcleft project. Methods & Procedures: Three parallel group, randomized, clinical trials were undertaken as an international multicentre study by nine cleft teams in five countries. Three different surgical protocols for primary palate repair (Arm B-Lip and soft palate closure at 3-4 months, hard palate closure at 36 months, Arm C-Lip closure at 3-4 months, hard and soft palate closure at 12 months, and Arm D-Lip closure at 3-4 months combined with a single-layer closure of the hard palate using a vomer flap, soft palate closure at 12 months) were tested against a common procedure (Arm A-Lip and soft palate closure at 3-4 months followed by hard palate closure at 12 months) in the total cohort of 431 children born with a non-syndromic UCLP. Speech audio and video recordings of 399 children were available and perceptually analysed. Percentage of consonants correct (PCC) from a naming test, an overall rating of velopharyngeal competence (VPC) (VPC-Rate), and a composite measure (VPC-Sum) were reported. Outcomes & Results: The mean levels of consonant proficiency (PCC score) in the trial arms were 86-92% and between 58% and 83% of the children had VPC (VPC-Sum). Only 50-73% of the participants had a consonant proficiency level with their peers. Girls performed better throughout. Long delay of the hard palate repair (Arm B) indicated lower PCC and simultaneous hard and soft palate closure higher (Arm C). However, the proportion of participants with primary VPC (not including velopharyngeal surgeries) was highest in Arm B (68%) and lowest in Arm C (47%). Conclusions & Implications: The speech outcome in terms of PCC and VPC was low across the trials. The different protocols had their pros and cons and there is no obvious evidence to recommend any of the protocols as superior. Aspects other than primary surgical method, such as time after velopharyngeal surgery, surgical experience, hearing level, language difficulties and speech therapy, need to be thoroughly reviewed for a better understanding of what has affected speech outcome at 10 years. (As Provided).
Anmerkungen	Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2024/1/01