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Scandcleft Project, Trial 1: Comparison of Speech Outcome in Relation to Timing of Hard Palate Closure in 5-Year-Olds With UCLP.

Journal article
Authors Elisabeth Willadsen
Anette Lohmander
Christina Persson
Maria Boers
Mia Kisling-Møller
Christina Havstam
Anna Elander
Mikael Andersen
Published in The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
Volume 56
Issue 10
Pages 1276-1286
ISSN 1545-1569
Publication year 2019
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Pages 1276-1286
Language en
Links dx.doi.org/10.1177/1055665619854632
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords 2-stage procedure; RCT; consonant proficiency; velopharyngeal function
Subject categories Plastic surgery, Logopedics and phoniatrics

Abstract

To compare in-depth speech results in Scandcleft Trial 1 as well as reference data from peers without cleft palate (CP).A prospective randomized clinical trial.A Danish and a Swedish CP center.143 of 148 randomized 5-year-olds with unilateral cleft lip and palate. All received lip and velum closure at 4 months, and hard palate closure at 12 months (arm A) or 36 months (arm B).A composite measure based on velopharyngeal competence (VPC) or velopharyngeal incompetence (VPI), an overall assessment of VPC from connected speech (VPC-Rate), Percentage of Consonants Correct (PCC-score), and consonant errors. Speech therapy visits, average hearing thresholds, and secondary pharyngeal surgeries documented burden of treatment.Across the trial, 61.5% demonstrated VPC and 38.5% VPI. Twenty-two percent of participants achieved age appropriate PCC-scores. There were no statistically significant differences between arms or centers for these measures. In the Danish center, arm B: achieved lower PCC-scores (P = .01); obtained PCC-scores without s-errors below 79% (P = .002); produced ≥3 active oral cleft speech characteristics (P = .004) than arm A. In both centers, arm B attended more speech visits.At age 5, differences between centers and treatment arms were not statistically significant for VPC/VPI, but consonant proficiency differed between treatment arms in the Danish center. Poor speech outcomes were seen for both treatment arms. Variations between centers were observed. As the Swedish center had few participants, intercenter comparisons should be interpreted with caution.

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