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Speech outcomes in 10-year-old children with complete unilateral cleft lip and palate after one-stage lip and palate repair in the first year of life.
J Plast Reconstr Aesthet Surg. 2012 Feb; 65(2):175-81.JP

Abstract

An evaluation of the results of one-stage repair of unilateral cleft lip and palate (UCLP) performed at the Institute of Mother and Child, Warsaw, Poland, has shown that the dentofacial outcomes are comparable with those of the best cleft centres. The aim of this study was to assess speech development after one-stage closure of UCLP. Twenty boys and eight girls at the mean age 9.6 years consecutively treated with one-stage closure of the cleft at the mean age of 8.8 (range, 6-13) months were included. The same surgeon performed palatal repair using a vomerplasty. The evaluated outcomes included (1) perceptual speech evaluations with assessment of hypernasality, audible nasal emissions (ANEs) and compensatory articulations, (2) evaluation of compensatory facial grimacing, (3) clinical intraoral evaluation and (4) videonasendoscopy when indicated. Our results demonstrated that 25 patients (89.3%) had normal nasal resonance. Severe hypernasality and compensatory articulation disorders caused by velopharyngeal insufficiency were assessed in one patient. In 13 patients (46.4%), oronasal fistulas were found. Two children (7%) with larger fistulas presented with mild hypernasality. In 11 cases (39.2%), fistula friction was heard at pronunciation of some anterior sounds. Ten children (35.7%) demonstrated compensatory facial grimacing, mostly inconsistent and mild, in the form of nasal valving. In conclusion, articulation development, velopharyngeal sphincter competence and incidence of compensatory articulations in our sample are satisfactory. However, only 54% of the present groups were rated as having entirely normal speech because of high incidences of anterior palatal fistulas, and mild but frequent fistula-related speech disturbances.

Authors+Show Affiliations

Centre for Craniofacial Disorders, Institute of Mother and Child, Warsaw, Poland.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21978731

Citation

Hortis-Dzierzbicka, Maria, et al. "Speech Outcomes in 10-year-old Children With Complete Unilateral Cleft Lip and Palate After One-stage Lip and Palate Repair in the First Year of Life." Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS, vol. 65, no. 2, 2012, pp. 175-81.
Hortis-Dzierzbicka M, Radkowska E, Fudalej PS. Speech outcomes in 10-year-old children with complete unilateral cleft lip and palate after one-stage lip and palate repair in the first year of life. J Plast Reconstr Aesthet Surg. 2012;65(2):175-81.
Hortis-Dzierzbicka, M., Radkowska, E., & Fudalej, P. S. (2012). Speech outcomes in 10-year-old children with complete unilateral cleft lip and palate after one-stage lip and palate repair in the first year of life. Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS, 65(2), 175-81. https://doi.org/10.1016/j.bjps.2011.09.015
Hortis-Dzierzbicka M, Radkowska E, Fudalej PS. Speech Outcomes in 10-year-old Children With Complete Unilateral Cleft Lip and Palate After One-stage Lip and Palate Repair in the First Year of Life. J Plast Reconstr Aesthet Surg. 2012;65(2):175-81. PubMed PMID: 21978731.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Speech outcomes in 10-year-old children with complete unilateral cleft lip and palate after one-stage lip and palate repair in the first year of life. AU - Hortis-Dzierzbicka,Maria, AU - Radkowska,Elzbieta, AU - Fudalej,Piotr S, Y1 - 2011/10/05/ PY - 2011/07/23/received PY - 2011/08/23/revised PY - 2011/09/06/accepted PY - 2011/10/8/entrez PY - 2011/10/8/pubmed PY - 2012/3/7/medline SP - 175 EP - 81 JF - Journal of plastic, reconstructive & aesthetic surgery : JPRAS JO - J Plast Reconstr Aesthet Surg VL - 65 IS - 2 N2 - An evaluation of the results of one-stage repair of unilateral cleft lip and palate (UCLP) performed at the Institute of Mother and Child, Warsaw, Poland, has shown that the dentofacial outcomes are comparable with those of the best cleft centres. The aim of this study was to assess speech development after one-stage closure of UCLP. Twenty boys and eight girls at the mean age 9.6 years consecutively treated with one-stage closure of the cleft at the mean age of 8.8 (range, 6-13) months were included. The same surgeon performed palatal repair using a vomerplasty. The evaluated outcomes included (1) perceptual speech evaluations with assessment of hypernasality, audible nasal emissions (ANEs) and compensatory articulations, (2) evaluation of compensatory facial grimacing, (3) clinical intraoral evaluation and (4) videonasendoscopy when indicated. Our results demonstrated that 25 patients (89.3%) had normal nasal resonance. Severe hypernasality and compensatory articulation disorders caused by velopharyngeal insufficiency were assessed in one patient. In 13 patients (46.4%), oronasal fistulas were found. Two children (7%) with larger fistulas presented with mild hypernasality. In 11 cases (39.2%), fistula friction was heard at pronunciation of some anterior sounds. Ten children (35.7%) demonstrated compensatory facial grimacing, mostly inconsistent and mild, in the form of nasal valving. In conclusion, articulation development, velopharyngeal sphincter competence and incidence of compensatory articulations in our sample are satisfactory. However, only 54% of the present groups were rated as having entirely normal speech because of high incidences of anterior palatal fistulas, and mild but frequent fistula-related speech disturbances. SN - 1878-0539 UR - https://www.unboundmedicine.com/medline/citation/21978731/Speech_outcomes_in_10_year_old_children_with_complete_unilateral_cleft_lip_and_palate_after_one_stage_lip_and_palate_repair_in_the_first_year_of_life_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1748-6815(11)00540-7 DB - PRIME DP - Unbound Medicine ER -