Greater Palatal Cleft Width Predicts an Increased Risk for Unfavorable Outcomes in Cleft Palate Repair
| Autor: | Monica Blom Johansson, Malin Hakelius, Fatemeh Jabbari, Åsa Okhiria, Daniel Nowinski |
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| Rok vydání: | 2021 |
| Předmět: |
Longitudinal study
Velopharyngeal Insufficiency Cleft Lip Nasal emission Dentistry 030230 surgery Dehiscence 03 medical and health sciences 0302 clinical medicine Velopharyngeal insufficiency Nose Diseases Medicine Humans Speech Longitudinal Studies Craniofacial Nasality Retrospective Studies Voice Disorders business.industry 030206 dentistry medicine.disease Cleft Palate Treatment Outcome Otorhinolaryngology Bilateral cleft lip Child Preschool Oral Surgery business Articulation (phonetics) |
| Zdroj: | The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. 59(8) |
| ISSN: | 1545-1569 |
| Popis: | Objective: To investigate the impact of cleft width and cleft type on the need for secondary surgery and velopharyngeal competence from a longitudinal perspective. Design: Retrospective, longitudinal study. Setting: A single multidisciplinary craniofacial team at a university hospital. Patients: Consecutive patients with unilateral or bilateral cleft lip and palate and cleft palate only (n = 313) born from 1984 to 2002, treated with 2-stage palatal surgery, were reviewed. A total of 213 patients were included. Main Outcome Measures: The impact of initial cleft width and cleft type on secondary surgery. Assessment of hypernasality, audible nasal emission, and glottal articulation from routine follow-ups from 3 to 16 years of age. The assessments were compared with reassessments of 10% of the recordings. Results: Cleft width, but not cleft type, predicted the need for secondary surgery, either due to palatal dehiscence or velopharyngeal insufficiency. The distribution of cleft width between the scale steps on a 4-point scale for hypernasality and audible nasal emission differed significantly at 5 years of age but not at any other age. Presence of glottal articulation differed significantly at 3 and 5 years of age. No differences between cleft types were seen at any age for any speech variable. Conclusions: Cleft width emerged as a predictor of the need for secondary surgery as well as more deviance in speech variables related to velopharyngeal competence during the preschool years. Cleft type was not related to the need for secondary surgery nor speech outcome at any age. |
| Databáze: | OpenAIRE |
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