Cleft Lip and Palate Care in the United Kingdom—The Clinical Standards Advisory Group (CSAG) Study. Part 3: Speech Outcomes

Sell, Debbie; Grunwell, Pamela; Mildinhall, Sue; Murphy, Terrie; Cornish, Tremaine A. O.; Bearn, David; Shaw, William C.; Murray, John; Williams, Alan G.; Sandy, Jonathan R

doi:10.1597/1545-1569_2001_038_0030_clapci_2.0.co_2

Cited by 117 publications

(116 citation statements)

References 22 publications

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“…Our results compare favourably with outcome of other cleft centres . The audit of the quality of care for children with CUCLP in the UK showed that the mean prevalence of hypernasality was 29% of the 5‐year‐olds and 32% of the 12‐year‐olds. The findings of the ‘Dutchcleft’ study – a three‐centre randomised clinical‐controlled trial into the effects of infant orthopaedics on craniofacial growth and speech development – demonstrated that hypernasality was present in more than 30% toddlers .…”

Section: Discussionsupporting

confidence: 66%

“…The current findings demonstrate that speech development in children with CUCLP treated with the one‐stage surgical protocol was satisfactory. The prevalence of hypernasality – an important outcome measure – was low in the whole cohort irrespective of the method of the hard palate repair. Our results compare favourably with outcome of other cleft centres .…”

Section: Discussionmentioning

confidence: 92%

“…The prevalence of hypernasality – an important outcome measure – was low in the whole cohort irrespective of the method of the hard palate repair. Our results compare favourably with outcome of other cleft centres . The audit of the quality of care for children with CUCLP in the UK showed that the mean prevalence of hypernasality was 29% of the 5‐year‐olds and 32% of the 12‐year‐olds.…”

Section: Discussionmentioning

confidence: 92%

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Speech outcome in complete unilateral cleft lip and palate – a comparison of three methods of the hard palate closure

Hortis-Dzierzbicka¹,

Radkowska²,

Stecko

et al. 2014

J of Oral Rehabilitation

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The aim of this study was to compare the speech in subjects with cleft lip and palate, in whom three methods of the hard palate closure were used. One hundred and thirty-seven children (96 boys, 41 girls; mean age = 12 years, SD = 1·2) with complete unilateral cleft lip and palate (CUCLP) operated by a single surgeon with a one-stage method were evaluated. The management of the cleft lip and soft palate was comparable in all subjects; for hard palate repair, three different methods were used: bilateral von Langenbeck closure (b-vL group, n = 39), unilateral von Langenbeck closure (u-vL group, n = 56) and vomerplasty (v-p group, n = 42). Speech was assessed: (i) perceptually for the presence of a) hypernasality, b) compensatory articulations (CAs), c) audible nasal air emissions (ANE) and d) speech intelligibility; (ii) for the presence of compensatory facial grimacing, (iii) with clinical intra-oral evaluation and (iv) with videonasendoscopy. A total rate of hypernasality requiring pharyngoplasty was 5·1%; total incidence post-oral compensatory articulations (CAs) was 2·2%. The overall speech intelligibility was good in 84·7% of cases. Oronasal fistulas (ONFs) occurred in 15·7% b-vL subjects, 7·1% u-vL subjects and 50% v-p subjects (P < 0·001). No statistically significant intergroup differences for hypernasality, CAs and intelligibility were found (P > 0·1). In conclusion, the speech after early one-stage repair of CUCLP was satisfactory. The method of hard palate repair affected the incidence of ONFs, which, however, caused relatively mild and inconsistent speech errors.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 92%

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Speech outcome in complete unilateral cleft lip and palate – a comparison of three methods of the hard palate closure

Hortis-Dzierzbicka¹,

Radkowska²,

Stecko

et al. 2014

J of Oral Rehabilitation

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“…These clinical measures have therefore been modified as the service has evolved. For speech, a validated measure has been developed , in contrast to the modified CAPS and a modification of the Eurocleft Speech study for articulation in CSAG . Differences between the two approaches are detailed in the speech study.…”

Section: Discussionmentioning

confidence: 99%

A cross‐sectional survey of 5‐year‐old children with non‐syndromic unilateral cleft lip and palate: the Cleft Care UK study. Part 1: background and methodology

Persson

Sandy

Waylen

et al. 2015

Orthod Craniofacial Res

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Structured AbstractObjectivesWe describe the methodology for a major study investigating the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after an initial survey, detailed in the Clinical Standards Advisory Group (CSAG) report in 1998, had informed government recommendations on centralization.Setting and Sample PopulationThis is a UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Children born between 1 April 2005 and 31 March 2007 were seen in cleft centre audit clinics.Materials and MethodsConsent was obtained for the collection of routine clinical measures (speech recordings, hearing, photographs, models, oral health, psychosocial factors) and anthropometric measures (height, weight, head circumference). The methodology for each clinical measure followed those of the earlier survey as closely as possible.ResultsWe identified 359 eligible children and recruited 268 (74.7%) to the study. Eleven separate records for each child were collected at the audit clinics. In total, 2666 (90.4%) were collected from a potential 2948 records. The response rates for the self-reported questionnaires, completed at home, were 52.6% for the Health and Lifestyle Questionnaire and 52.2% for the Satisfaction with Service Questionnaire.ConclusionsResponse rates and measures were similar to those achieved in the previous survey. There are practical, administrative and methodological challenges in repeating cross-sectional surveys 15 years apart and producing comparable data.

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“…18% of 5-and 12-year-olds had consistent hypernasality of mild, moderate, or severe degree. Approximately two-thirds of both age groups had undergone speech therapy [88]. In India where unoperated adult cleft lip and palate is a significant problem, very few achieved normal speech [86], and communication is hampered by hearing problems with 76% of unoperated cleft palate patients showing mild to moderate conductive deafness [89].…”

Section: Quantifying the Morbidity Due To Ofcmentioning

confidence: 99%

Epidemiology of Oral Clefts 2012: An International Perspective

Mossey

Modell

2012

Frontiers of Oral Biology

463

422

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Classical descriptive epidemiology in the field of cleft lip and palate aims to quantify the problem, and in the higher income countries it is possible to do this with varying degrees of accuracy. This is not however possible in every country in the world, and epidemiology should seek to identify these data gaps with a view to improvement in the situation. Epidemiology must also be investigative and look for trends, associations and inter-population differences, with the aim of supporting aetiological research and advancing the translational agenda. This chapter is set out in three parts and seeks to address all three of the above areas. Birth defects in general and orofacial clefting in particular remain a relatively common and significant problem for not only the individual patients born with these defects in terms of death or disability, but also for their families and for society in general in terms of burden of care and health inequality. In high-income countries, despite very significant advances in treatment, problems in access to care and evidence base for cleft care still exist whereas in the developing world the consequences are lack of access to care and lack of infrastructure to help with quantification of the problem and consequently the ability to address it. The major questions in contemporary cleft lip and palate research surround ways of improving the evidence base for the treatment interventions used to optimise quality of care, and the ultimate scientific and humanitarian objective is primary prevention of those diseases and disorders that are preventable. Descriptive epidemiology underpins research enquiry in both of these major areas.

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Cleft Lip and Palate Care in the United Kingdom—The Clinical Standards Advisory Group (CSAG) Study. Part 3: Speech Outcomes

Cited by 117 publications

References 22 publications

Speech outcome in complete unilateral cleft lip and palate – a comparison of three methods of the hard palate closure

Speech outcome in complete unilateral cleft lip and palate – a comparison of three methods of the hard palate closure

A cross‐sectional survey of 5‐year‐old children with non‐syndromic unilateral cleft lip and palate: the Cleft Care UK study. Part 1: background and methodology

Epidemiology of Oral Clefts 2012: An International Perspective

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