TY - JOUR
T1 - Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate
T2 - 5. Speech outcomes in 5-year-olds - consonant proficiency and errors
AU - Willadsen, Elisabeth
AU - Lohmander, Anette
AU - Persson, Christina
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 - Andersen, Helene Søgaard
AU - Schöps, Antje
AU - Tørdal, Inger Beate
AU - Semb, Gunvor
PY - 2017/2
Y1 - 2017/2
N2 - BACKGROUND AND AIM: Normal articulation before school start is a main objective in cleft palate treatment. The aim was to investigate if differences exist in consonant proficiency at age 5 years between children with unilateral cleft lip and palate (UCLP) randomised to different surgical protocols 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, Norway, Sweden, 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 non-syndromic UCLP. Speech audio- and video-recordings of 391 children (136 girls and 255 boys) were available and transcribed phonetically. The main outcome measure was Percent Consonants Correct (PCC) from blinded assessments.RESULTS: In Trial 1, arm A showed statistically significant higher PCC scores (82%) than arm B (78%) (p = .045). No significant differences were found between prevalences in Trial 2, A: 79%, C: 82%; or Trial 3, A: 80%, D: 85%. Across all trials, girls achieved better PCC scores, excluding s-errors, than boys (91.0% and 87.5%, respectively) (p = .01).CONCLUSIONS: PCC scores were higher in arm A than B in Trial 1, whereas no differences were found between arms in Trials 2 or 3. 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: Normal articulation before school start is a main objective in cleft palate treatment. The aim was to investigate if differences exist in consonant proficiency at age 5 years between children with unilateral cleft lip and palate (UCLP) randomised to different surgical protocols 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, Norway, Sweden, 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 non-syndromic UCLP. Speech audio- and video-recordings of 391 children (136 girls and 255 boys) were available and transcribed phonetically. The main outcome measure was Percent Consonants Correct (PCC) from blinded assessments.RESULTS: In Trial 1, arm A showed statistically significant higher PCC scores (82%) than arm B (78%) (p = .045). No significant differences were found between prevalences in Trial 2, A: 79%, C: 82%; or Trial 3, A: 80%, D: 85%. Across all trials, girls achieved better PCC scores, excluding s-errors, than boys (91.0% and 87.5%, respectively) (p = .01).CONCLUSIONS: PCC scores were higher in arm A than B in Trial 1, whereas no differences were found between arms in Trials 2 or 3. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed.TRIAL REGISTRATION: ISRCTN29932826.
KW - Journal Article
U2 - 10.1080/2000656X.2016.1254647
DO - 10.1080/2000656X.2016.1254647
M3 - Journal article
C2 - 28218556
SN - 2000-656X
VL - 51
SP - 38
EP - 51
JO - Journal of Plastic Surgery and Hand Surgery
JF - Journal of Plastic Surgery and Hand Surgery
IS - 1
ER -