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Region Hovedstaden - en del af Københavns Universitetshospital
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Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 5. Speech outcomes in 5-year-olds - consonant proficiency and errors

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  • Elisabeth Willadsen
  • Anette Lohmander
  • Christina Persson
  • Inger Lundeborg
  • Suvi Alaluusua
  • Ragnhild Aukner
  • Anja Bau
  • Maria Boers
  • Melanie Bowden
  • Julie Davies
  • Berit Emborg
  • Christina Havstam
  • Christine Hayden
  • Gunilla Henningsson
  • Anders Holmefjord
  • Elina Hölttä
  • Mia Kisling-Møller
  • Lillian Kjøll
  • Maria Lundberg
  • Eilish McAleer
  • Jill Nyberg
  • Marjukka Paaso
  • Nina-Helen Pedersen
  • Therese Rasmussen
  • Sigvor Reisæter
  • Helene Søgaard Andersen
  • Antje Schöps
  • Inger Beate Tørdal
  • Gunvor Semb
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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.

OriginalsprogEngelsk
TidsskriftJournal of Plastic Surgery and Hand Surgery
Vol/bind51
Udgave nummer1
Sider (fra-til)38-51
Antal sider14
ISSN2000-656X
DOI
StatusUdgivet - feb. 2017

ID: 51555789