Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes
Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCL...
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2017-05-01
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| Series: | Archives of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2017.44.3.202 |
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| author | Isabelle Francisca Petronella Maria Kappen Dirk Bittermann Laura Janssen Gerhard Koendert Pieter Bittermann Chantal Boonacker Sarah Haverkamp Hester de Wilde Marise Van Der Heul Tom FJMC Specken Ron Koole Moshe Kon Corstiaan Cornelis Breugem Aebele Barber Mink van der Molen |
| author_facet | Isabelle Francisca Petronella Maria Kappen Dirk Bittermann Laura Janssen Gerhard Koendert Pieter Bittermann Chantal Boonacker Sarah Haverkamp Hester de Wilde Marise Van Der Heul Tom FJMC Specken Ron Koole Moshe Kon Corstiaan Cornelis Breugem Aebele Barber Mink van der Molen |
| author_sort | Isabelle Francisca Petronella Maria Kappen |
| collection | DOAJ |
| description | Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP).
Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation.
Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%–17% of the patients exhibited increased nasalance scores, assessed through nasometry.
Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence. |
| first_indexed | 2024-04-14T00:27:34Z |
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| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-04-14T00:27:34Z |
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| publisher | Thieme Medical Publishers, Inc. |
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| series | Archives of Plastic Surgery |
| spelling | doaj.art-8b8dce60bc0f481b8de5f8ff43e5f3e32022-12-22T02:22:40ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712017-05-01440320220910.5999/aps.2017.44.3.202789Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech OutcomesIsabelle Francisca Petronella Maria Kappen0Dirk Bittermann1Laura Janssen2Gerhard Koendert Pieter Bittermann3Chantal Boonacker4Sarah Haverkamp5Hester de Wilde6Marise Van Der Heul7Tom FJMC Specken8Ron Koole9Moshe Kon10Corstiaan Cornelis Breugem11Aebele Barber Mink van der Molen12Department of Plastic Surgery, University of Utrecht, Utrecht, The NetherlandsDepartment of Maxillofacial Surgery, University Medical Centre of Utrecht, Utrecht, The NetherlandsDepartment of Plastic Surgery, University Medical Centre of Utrecht, Utrecht, The NetherlandsDepartment of Maxillofacial Surgery, University Medical Centre of Utrecht, Utrecht, The NetherlandsJulius Centre for Health Sciences and Primary Care, University Medical Centre of Utrecht, Utrecht, The NetherlandsSpeech and Language Pathology, ENT-Surgery, University Medical Centre of Utrecht, Utrecht, The NetherlandsSpeech and Language Pathology, ENT-Surgery, University Medical Centre of Utrecht, Utrecht, The NetherlandsSpeech and Language Pathology, ENT-Surgery, University Medical Centre of Utrecht, Utrecht, The NetherlandsDepartment of Plastic Surgery, University Medical Centre of Utrecht, Utrecht, The NetherlandsSpeech and Language Pathology, ENT-Surgery, University Medical Centre of Utrecht, Utrecht, The NetherlandsDepartment of Plastic Surgery, University Medical Centre of Utrecht, Utrecht, The NetherlandsDepartment of Plastic Surgery, University Medical Centre of Utrecht, Utrecht, The NetherlandsDepartment of Plastic Surgery, University of Utrecht, Utrecht, The NetherlandsBackground No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%–17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2017.44.3.202cleft lip with or without cleft palate, nonsyndromiccleft lipcleft palateadultspeech |
| spellingShingle | Isabelle Francisca Petronella Maria Kappen Dirk Bittermann Laura Janssen Gerhard Koendert Pieter Bittermann Chantal Boonacker Sarah Haverkamp Hester de Wilde Marise Van Der Heul Tom FJMC Specken Ron Koole Moshe Kon Corstiaan Cornelis Breugem Aebele Barber Mink van der Molen Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes Archives of Plastic Surgery cleft lip with or without cleft palate, nonsyndromic cleft lip cleft palate adult speech |
| title | Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes |
| title_full | Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes |
| title_fullStr | Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes |
| title_full_unstemmed | Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes |
| title_short | Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes |
| title_sort | long term follow up study of young adults treated for unilateral complete cleft lip alveolus and palate by a treatment protocol including two stage palatoplasty speech outcomes |
| topic | cleft lip with or without cleft palate, nonsyndromic cleft lip cleft palate adult speech |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2017.44.3.202 |
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