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Speech outcomes at 5 and 10 years of age after one-stage palatal repair with muscle reconstruction in children born with isolated cleft palate.
J Plast Surg Hand Surg. 2018 Feb; 52(1):20-29.JP

Abstract

BACKGROUND

The aim of this study was to investigate speech outcomes in children with clefts in the hard and/or soft palate only (CPH/CPS), in order to determine the prevalence of cleft speech characteristics, the change between 5 and 10 years of age, and the difference in occurrence between CPH and CPS.

METHODS

A consecutive series of 88 children born with CPH or CPS were included in a retrospective cohort. All participants were treated with one-stage palatal repair using a minimal incision technique with muscle reconstruction (mean age 13 months). Twelve children (14%) received a velopharyngeal flap. Cleft speech variables were rated at 5 and 10 years of age independently by three experienced external speech-language pathologists. Inter- and intra-rater agreements were determined, and the prevalence of cleft speech characteristics was calculated.

RESULTS

Moderate-to-severe hypernasality and weak pressure consonants were present in 5%-10% of the children at 5 years, with marginal but statistically significant improvement at 10 years of age. Frequently or always occurring audible nasal air leakage was detected in 20% of children at age 5, and increased to ∼35% of the children at 10 years. Ten per cent had compensatory articulation at age 5, and 25% demonstrated s-distortions, whereas few had these problems at age 10.

CONCLUSIONS

The results demonstrate low occurrence of compensatory articulation problems in this cohort, even by 5 years of age. The high presence of symptoms of velopharyngeal insufficiency at 10 years of age suggests a need for additional secondary velopharyngeal surgery.

Authors+Show Affiliations

a Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology , Karolinska Institutet , Stockholm , Sweden. b Department of Reconstructive Plastic Surgery , Karolinska University Hospital , Stockholm , Sweden. c Functional Area Speech & Language Pathology , Karolinska University Hospital , Stockholm , Sweden.b Department of Reconstructive Plastic Surgery , Karolinska University Hospital , Stockholm , Sweden. d Department of Molecular Medicine and Surgery , Karolinska Institutet , Stockholm , Sweden.a Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology , Karolinska Institutet , Stockholm , Sweden. c Functional Area Speech & Language Pathology , Karolinska University Hospital , Stockholm , Sweden.

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

28460587

Citation

Nyberg, Jill, et al. "Speech Outcomes at 5 and 10 Years of Age After One-stage Palatal Repair With Muscle Reconstruction in Children Born With Isolated Cleft Palate." Journal of Plastic Surgery and Hand Surgery, vol. 52, no. 1, 2018, pp. 20-29.
Nyberg J, Neovius E, Lohmander A. Speech outcomes at 5 and 10 years of age after one-stage palatal repair with muscle reconstruction in children born with isolated cleft palate. J Plast Surg Hand Surg. 2018;52(1):20-29.
Nyberg, J., Neovius, E., & Lohmander, A. (2018). Speech outcomes at 5 and 10 years of age after one-stage palatal repair with muscle reconstruction in children born with isolated cleft palate. Journal of Plastic Surgery and Hand Surgery, 52(1), 20-29. https://doi.org/10.1080/2000656X.2017.1316282
Nyberg J, Neovius E, Lohmander A. Speech Outcomes at 5 and 10 Years of Age After One-stage Palatal Repair With Muscle Reconstruction in Children Born With Isolated Cleft Palate. J Plast Surg Hand Surg. 2018;52(1):20-29. PubMed PMID: 28460587.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Speech outcomes at 5 and 10 years of age after one-stage palatal repair with muscle reconstruction in children born with isolated cleft palate. AU - Nyberg,Jill, AU - Neovius,Erik, AU - Lohmander,Anette, Y1 - 2017/05/02/ PY - 2017/5/4/pubmed PY - 2018/9/1/medline PY - 2017/5/3/entrez KW - Cleft palate KW - VPI KW - cleft palate repair KW - compensatory articulation KW - secondary velopharyngeal surgery hypernasality SP - 20 EP - 29 JF - Journal of plastic surgery and hand surgery JO - J Plast Surg Hand Surg VL - 52 IS - 1 N2 - BACKGROUND: The aim of this study was to investigate speech outcomes in children with clefts in the hard and/or soft palate only (CPH/CPS), in order to determine the prevalence of cleft speech characteristics, the change between 5 and 10 years of age, and the difference in occurrence between CPH and CPS. METHODS: A consecutive series of 88 children born with CPH or CPS were included in a retrospective cohort. All participants were treated with one-stage palatal repair using a minimal incision technique with muscle reconstruction (mean age 13 months). Twelve children (14%) received a velopharyngeal flap. Cleft speech variables were rated at 5 and 10 years of age independently by three experienced external speech-language pathologists. Inter- and intra-rater agreements were determined, and the prevalence of cleft speech characteristics was calculated. RESULTS: Moderate-to-severe hypernasality and weak pressure consonants were present in 5%-10% of the children at 5 years, with marginal but statistically significant improvement at 10 years of age. Frequently or always occurring audible nasal air leakage was detected in 20% of children at age 5, and increased to ∼35% of the children at 10 years. Ten per cent had compensatory articulation at age 5, and 25% demonstrated s-distortions, whereas few had these problems at age 10. CONCLUSIONS: The results demonstrate low occurrence of compensatory articulation problems in this cohort, even by 5 years of age. The high presence of symptoms of velopharyngeal insufficiency at 10 years of age suggests a need for additional secondary velopharyngeal surgery. SN - 2000-6764 UR - https://www.unboundmedicine.com/medline/citation/28460587/Speech_outcomes_at_5_and_10_years_of_age_after_one_stage_palatal_repair_with_muscle_reconstruction_in_children_born_with_isolated_cleft_palate_ L2 - http://www.tandfonline.com/doi/full/10.1080/2000656X.2017.1316282 DB - PRIME DP - Unbound Medicine ER -