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Influence of Infant Cleft Dimensions on Velopharyngeal Function in 5-Year-Old Danish Children Born With Unilateral Cleft Lip and Palate

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Botticelli, Susanna ; Küseler, Annelise ; Mølsted, Kirsten ; Andersen, Helene Soegaard ; Boers, Maria ; Shoeps, Antje ; Emborg, Berit Kildegaard ; Kisling-Møller, Mia ; Pedersen, Thomas Klit ; Andersen, Mikael ; Willadsen, Elisabeth. / Influence of Infant Cleft Dimensions on Velopharyngeal Function in 5-Year-Old Danish Children Born With Unilateral Cleft Lip and Palate. In: Cleft Palate-Craniofacial Journal. 2020 ; Vol. 57, No. 4. pp. 420-429.

Bibtex

@article{501b7bc0086441ec9af178db34169562,
title = "Influence of Infant Cleft Dimensions on Velopharyngeal Function in 5-Year-Old Danish Children Born With Unilateral Cleft Lip and Palate",
abstract = "AIM: To examine the association of cleft severity at infancy and velopharyngeal competence in preschool children with unilateral cleft lip and palate operated with early or delayed hard palate repair.DESIGN: Subgroup analysis within a multicenter randomized controlled trial of primary surgery (Scandcleft).SETTING: Tertiary health care. One surgical center.PATIENTS AND METHODS: One hundred twenty-five infants received cheilo-rhinoplasty and soft palate repair at age 3 to 4 months and were randomized to hard palate closure at age 12 or 36 months. Cleft size and cleft morphology were measured 3 dimensionally on digital models, obtained by laser surface scanning of preoperative plaster models (mean age: 1.8 months).MAIN OUTCOME MEASUREMENTS: Velopharyngeal competence (VPC) and hypernasality assessed from a naming test (VPC-Sum) and connected speech (VPC-Rate). In both scales, higher scores indicated a more severe velopharyngeal insufficiency.RESULTS: No difference between surgical groups was shown. A low positive correlation was found between posterior cleft width and VPC-Rate (Spearman = .23; P = .025). The role of the covariate {"}cleft size at tuberosity level{"} was confirmed in an ordinal logistic regression model (odds ratio [OR] = 1.17; 95{\%} confidence interval [CI]:1.01-1.35). A low negative correlation was shown between anteroposterior palatal length and VPC-Sum (Spearman = -.27; P = .004) and confirmed by the pooled scores VPC-Pooled (OR = 0.82; 95{\%} CI: 0.69-0.98) and VPC-Dichotomic (OR = 0.82; 95{\%} CI: 0.68-0.99).CONCLUSIONS: Posterior cleft dimensions can be a modest indicator for the prognosis of velopharyngeal function at age 5 years, when the soft palate is closed first, independently on the timing of hard palate repair. Antero-posterior palatal length seems to protect from velopharyngeal insufficiency and hypernasality. However, the association found was significant but low.",
keywords = "hard palate, nonsyndromic clefting, speech development, surgical technique, velopharyngeal function",
author = "Susanna Botticelli and Annelise K{\"u}seler and Kirsten M{\o}lsted and Andersen, {Helene Soegaard} and Maria Boers and Antje Shoeps and Emborg, {Berit Kildegaard} and Mia Kisling-M{\o}ller and Pedersen, {Thomas Klit} and Mikael Andersen and Elisabeth Willadsen",
year = "2020",
month = "4",
doi = "10.1177/1055665619874143",
language = "English",
volume = "57",
pages = "420--429",
journal = "Cleft Palate-Craniofacial Journal",
issn = "1055-6656",
publisher = "Allen Press Inc",
number = "4",

}

RIS

TY - JOUR

T1 - Influence of Infant Cleft Dimensions on Velopharyngeal Function in 5-Year-Old Danish Children Born With Unilateral Cleft Lip and Palate

AU - Botticelli, Susanna

AU - Küseler, Annelise

AU - Mølsted, Kirsten

AU - Andersen, Helene Soegaard

AU - Boers, Maria

AU - Shoeps, Antje

AU - Emborg, Berit Kildegaard

AU - Kisling-Møller, Mia

AU - Pedersen, Thomas Klit

AU - Andersen, Mikael

AU - Willadsen, Elisabeth

PY - 2020/4

Y1 - 2020/4

N2 - AIM: To examine the association of cleft severity at infancy and velopharyngeal competence in preschool children with unilateral cleft lip and palate operated with early or delayed hard palate repair.DESIGN: Subgroup analysis within a multicenter randomized controlled trial of primary surgery (Scandcleft).SETTING: Tertiary health care. One surgical center.PATIENTS AND METHODS: One hundred twenty-five infants received cheilo-rhinoplasty and soft palate repair at age 3 to 4 months and were randomized to hard palate closure at age 12 or 36 months. Cleft size and cleft morphology were measured 3 dimensionally on digital models, obtained by laser surface scanning of preoperative plaster models (mean age: 1.8 months).MAIN OUTCOME MEASUREMENTS: Velopharyngeal competence (VPC) and hypernasality assessed from a naming test (VPC-Sum) and connected speech (VPC-Rate). In both scales, higher scores indicated a more severe velopharyngeal insufficiency.RESULTS: No difference between surgical groups was shown. A low positive correlation was found between posterior cleft width and VPC-Rate (Spearman = .23; P = .025). The role of the covariate "cleft size at tuberosity level" was confirmed in an ordinal logistic regression model (odds ratio [OR] = 1.17; 95% confidence interval [CI]:1.01-1.35). A low negative correlation was shown between anteroposterior palatal length and VPC-Sum (Spearman = -.27; P = .004) and confirmed by the pooled scores VPC-Pooled (OR = 0.82; 95% CI: 0.69-0.98) and VPC-Dichotomic (OR = 0.82; 95% CI: 0.68-0.99).CONCLUSIONS: Posterior cleft dimensions can be a modest indicator for the prognosis of velopharyngeal function at age 5 years, when the soft palate is closed first, independently on the timing of hard palate repair. Antero-posterior palatal length seems to protect from velopharyngeal insufficiency and hypernasality. However, the association found was significant but low.

AB - AIM: To examine the association of cleft severity at infancy and velopharyngeal competence in preschool children with unilateral cleft lip and palate operated with early or delayed hard palate repair.DESIGN: Subgroup analysis within a multicenter randomized controlled trial of primary surgery (Scandcleft).SETTING: Tertiary health care. One surgical center.PATIENTS AND METHODS: One hundred twenty-five infants received cheilo-rhinoplasty and soft palate repair at age 3 to 4 months and were randomized to hard palate closure at age 12 or 36 months. Cleft size and cleft morphology were measured 3 dimensionally on digital models, obtained by laser surface scanning of preoperative plaster models (mean age: 1.8 months).MAIN OUTCOME MEASUREMENTS: Velopharyngeal competence (VPC) and hypernasality assessed from a naming test (VPC-Sum) and connected speech (VPC-Rate). In both scales, higher scores indicated a more severe velopharyngeal insufficiency.RESULTS: No difference between surgical groups was shown. A low positive correlation was found between posterior cleft width and VPC-Rate (Spearman = .23; P = .025). The role of the covariate "cleft size at tuberosity level" was confirmed in an ordinal logistic regression model (odds ratio [OR] = 1.17; 95% confidence interval [CI]:1.01-1.35). A low negative correlation was shown between anteroposterior palatal length and VPC-Sum (Spearman = -.27; P = .004) and confirmed by the pooled scores VPC-Pooled (OR = 0.82; 95% CI: 0.69-0.98) and VPC-Dichotomic (OR = 0.82; 95% CI: 0.68-0.99).CONCLUSIONS: Posterior cleft dimensions can be a modest indicator for the prognosis of velopharyngeal function at age 5 years, when the soft palate is closed first, independently on the timing of hard palate repair. Antero-posterior palatal length seems to protect from velopharyngeal insufficiency and hypernasality. However, the association found was significant but low.

KW - hard palate

KW - nonsyndromic clefting

KW - speech development

KW - surgical technique

KW - velopharyngeal function

U2 - 10.1177/1055665619874143

DO - 10.1177/1055665619874143

M3 - Journal article

VL - 57

SP - 420

EP - 429

JO - Cleft Palate-Craniofacial Journal

JF - Cleft Palate-Craniofacial Journal

SN - 1055-6656

IS - 4

ER -

ID: 59410259