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Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 5. Speech outcomes in 5-year-olds - consonant proficiency and errors.

Journal article
Authors Elisabeth Willadsen
Anette Lohmander
Christina Persson
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
Published in Journal of plastic surgery and hand surgery
Volume 51
Issue 1
Pages 38-51
ISSN 2000-6764
Publication year 2017
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Pages 38-51
Language en
Subject categories Logopedics and phoniatrics


Normal articulation before school start is a main objective in cleft palate treatment. The aim was to investigate if differences exist in consonant proficiency at age 5 years between children with unilateral cleft lip and palate (UCLP) randomised to different surgical protocols for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy.Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Norway, Sweden, and the UK.Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with non-syndromic UCLP. Speech audio- and video-recordings of 391 children (136 girls and 255 boys) were available and transcribed phonetically. The main outcome measure was Percent Consonants Correct (PCC) from blinded assessments.In Trial 1, arm A showed statistically significant higher PCC scores (82%) than arm B (78%) (p = .045). No significant differences were found between prevalences in Trial 2, A: 79%, C: 82%; or Trial 3, A: 80%, D: 85%. Across all trials, girls achieved better PCC scores, excluding s-errors, than boys (91.0% and 87.5%, respectively) (p = .01).PCC scores were higher in arm A than B in Trial 1, whereas no differences were found between arms in Trials 2 or 3. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed.ISRCTN29932826.

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