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Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 4. Speech outcomes in 5-year-olds - velopharyngeal competency and hypernasality

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  3. A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management

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  4. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 6. Dental arch relationships in 5 year-olds

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  • Anette Lohmander
  • Christina Persson
  • Elisabeth Willadsen
  • 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: 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.

Original languageEnglish
JournalJournal of Plastic Surgery and Hand Surgery
Volume51
Issue number1
Pages (from-to)27-37
Number of pages11
ISSN2000-656X
DOIs
Publication statusPublished - Feb 2017

    Research areas

  • Journal Article

ID: 51555659