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

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

doi:10.1080/2000656X.2016.1254645

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

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 McAleerJill Nyberg, Marjukka Paaso, Nina Helen Pedersen, Therese Rasmussen, Sigvor Reisæter, Helene Søgaard Andersen, Antje Schöps, Inger Beate Tørdal, Gunvor Semb

^*Corresponding author for this work

Department of Nordic Studies and Linguistics

30 Citations (Scopus)

Abstract

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 language	English
Journal	Journal of Plastic Surgery and Hand Surgery
Volume	51
Issue number	1
Pages (from-to)	27-37
Number of pages	11
ISSN	2000-656X
DOIs	https://doi.org/10.1080/2000656X.2016.1254645
Publication status	Published - 2017

Keywords

cross-linguistic
intercentre study
primary palatal repair
Randomised clinical trial
Scandcleft
speech
unilateral cleft lip and palate

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10.1080/2000656X.2016.1254645

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Lohmander, A., Persson, C., Willadsen, E., Lundeborg, I., Alaluusua, S., Aukner, R., Bau, A., Boers, M., Bowden, M., Davies, J., Emborg, B., Havstam, C., Hayden, C., Henningsson, G., Holmefjord, A., Hölttä, E., Kisling-Møller, M., Kjøll, L., Lundberg, M., ... Semb, G. (2017). Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 4. Speech outcomes in 5-year-olds - velopharyngeal competency and hypernasality. Journal of Plastic Surgery and Hand Surgery, 51(1), 27-37. https://doi.org/10.1080/2000656X.2016.1254645

Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate : 4. Speech outcomes in 5-year-olds - velopharyngeal competency and hypernasality. / Lohmander, Anette; Persson, Christina; Willadsen, Elisabeth et al.

In: Journal of Plastic Surgery and Hand Surgery, Vol. 51, No. 1, 2017, p. 27-37.

Research output: Contribution to journal › Journal article › Research › peer-review

Lohmander, A, Persson, C, Willadsen, E, Lundeborg, I, Alaluusua, S, Aukner, R, Bau, A, Boers, M, Bowden, M, Davies, J, Emborg, B, Havstam, C, Hayden, C, Henningsson, G, Holmefjord, A, Hölttä, E, Kisling-Møller, M, Kjøll, L, Lundberg, M, McAleer, E, Nyberg, J, Paaso, M, Pedersen, NH, Rasmussen, T, Reisæter, S, Søgaard Andersen, H, Schöps, A, Tørdal, IB & Semb, G 2017, 'Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 4. Speech outcomes in 5-year-olds - velopharyngeal competency and hypernasality', Journal of Plastic Surgery and Hand Surgery, vol. 51, no. 1, pp. 27-37. https://doi.org/10.1080/2000656X.2016.1254645

@article{d1b28c6fcf944ff8bdcac838cd73d410,

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

abstract = "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.",

keywords = "cross-linguistic, intercentre study, primary palatal repair, Randomised clinical trial, Scandcleft, speech, unilateral cleft lip and palate",

author = "Anette Lohmander and Christina Persson and Elisabeth Willadsen and Inger Lundeborg and Suvi Alaluusua and Ragnhild Aukner and Anja Bau and Maria Boers and Melanie Bowden and Julie Davies and Berit Emborg and Christina Havstam and Christine Hayden and Gunilla Henningsson and Anders Holmefjord and Elina H{\"o}ltt{\"a} and Mia Kisling-M{\o}ller and Lillian Kj{\o}ll and Maria Lundberg and Eilish McAleer and Jill Nyberg and Marjukka Paaso and Pedersen, {Nina Helen} and Therese Rasmussen and Sigvor Reis{\ae}ter and {S{\o}gaard Andersen}, Helene and Antje Sch{\"o}ps and T{\o}rdal, {Inger Beate} and Gunvor Semb",

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doi = "10.1080/2000656X.2016.1254645",

language = "English",

volume = "51",

pages = "27--37",

journal = "Journal of Plastic Surgery and Hand Surgery",

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TY - JOUR

T1 - Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

T2 - 4. Speech outcomes in 5-year-olds - velopharyngeal competency and hypernasality

AU - Lohmander, Anette

AU - Persson, Christina

AU - Willadsen, Elisabeth

AU - Lundeborg, Inger

AU - Alaluusua, Suvi

AU - Aukner, Ragnhild

AU - Bau, Anja

AU - Boers, Maria

AU - Bowden, Melanie

AU - Davies, Julie

AU - Emborg, Berit

AU - Havstam, Christina

AU - Hayden, Christine

AU - Henningsson, Gunilla

AU - Holmefjord, Anders

AU - Hölttä, Elina

AU - Kisling-Møller, Mia

AU - Kjøll, Lillian

AU - Lundberg, Maria

AU - McAleer, Eilish

AU - Nyberg, Jill

AU - Paaso, Marjukka

AU - Pedersen, Nina Helen

AU - Rasmussen, Therese

AU - Reisæter, Sigvor

AU - Søgaard Andersen, Helene

AU - Schöps, Antje

AU - Tørdal, Inger Beate

AU - Semb, Gunvor

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - cross-linguistic

KW - intercentre study

KW - primary palatal repair

KW - Randomised clinical trial

KW - Scandcleft

KW - speech

KW - unilateral cleft lip and palate

U2 - 10.1080/2000656X.2016.1254645

DO - 10.1080/2000656X.2016.1254645

M3 - Journal article

C2 - 28218551

AN - SCOPUS:85013436474

SN - 2000-656X

VL - 51

SP - 27

EP - 37

JO - Journal of Plastic Surgery and Hand Surgery

JF - Journal of Plastic Surgery and Hand Surgery

IS - 1

ER -

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

Abstract

Keywords

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