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.
10.5999/aps.2017.44.3.202
- Author:
Isabelle Francisca Petronella Maria KAPPEN
1
;
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 Information
1. Department of Plastic Surgery, University of Utrecht, Utrecht, The Netherlands. isabellekappen@me.com
- Publication Type:Original Article
- Keywords:
Cleft lip with or without cleft palate, nonsyndromic;
Cleft lip;
Cleft palate;
Adult;
Speech
- MeSH:
Adult;
Cleft Lip*;
Cleft Palate;
Clinical Protocols*;
Consensus;
Follow-Up Studies*;
Humans;
Incidence;
Palate*;
Palate, Hard;
Palate, Soft;
Retrospective Studies;
Young Adult*
- From:Archives of Plastic Surgery
2017;44(3):202-209
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
