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KMID : 1038220170440030202
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Archives of Plastic Surgery
2017 Volume.44 No. 3 p.202 ~ p.209
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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
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Kappen Isabelle Francisca Petronella Maria
Bittermann Dirk
Janssen Laura
Bittermann Gerhard Koendert Pieter
Boonacker Chantal
Haverkamp Sarah
Heul Marise Van Der
Specken Tom FJMC
Koole Ron
Kon Moshe
Breugem Corstiaan Cornelis
van der Molen Aebele Barber Mink
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Abstract
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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.
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KEYWORD
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Cleft lip with or without cleft palate, nonsyndromic, Cleft lip, Cleft palate, Adult, Speech
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