Speech in 5-Year-Olds With Cleft Palate With or Without Cleft Lip Treated With Primary Palatal Surgery With Muscle Reconstruction According to Sommerlad

Klintö, Kristina; Falk, Evelina; Wilhelmsson, Sara; Schönmeyr, Björn; Becker, Magnus

doi:10.1177/1055665618768541

Cited by 17 publications

(32 citation statements)

References 29 publications

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“…Others have published on the Sommerlad soft palate repair technique (Andrades et al, 2008; Becker & Hansson, 2013; Doucet et al, 2013; Luyten et al, 2013; 2014; Yang et al, 2013; Cairns et al, 2014; Moar et al, 2016; Rossell-Perry et al, 2015; Dissaux et al, 2016; Nyberg et al, 2018; Bruneel et al, 2018; Klinto et al, 2018; Mapar et al, 2019; Smyth & Wu, 2019). In 3 studies, the Sommerlad intravelar veloplasty was part of a protocol of delayed hard palate closure (Doucet et al, 2013; Dissaux et al, 2016; Klinto et al, 2018 [in 2 of 3 centers]); in another 2 studies, gold standard speech methodology was not used (Andrades et al, 2008; Yang et al, 2013); in 3 studies detailed speech results were not given (Becker & Hansson, 2013; Rossell-Perry et al, 2015; Moar et al, 2016). The Luyten et al (2014) study is subject to bias due to different surgeons in different countries and different languages of the speech and language therapists and participants (Hutters & Henningsson, 2004).…”

Section: Introductionmentioning

confidence: 99%

Benchmarking Speech, Velopharyngeal Function Outcomes and Surgical Characteristics Following the Sommerlad Protocol and Palate Repair Technique

Baillie

Sell

2020

The Cleft Palate Craniofacial Journal

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Objective: To report speech and velopharyngeal function (VPF) outcomes, and surgical characteristics, at age 5 following early complete palate closure using the Sommerlad protocol. Design: A retrospective, descriptive, cross-sectional consecutive series. Setting: A regional twin site center; a district general hospital and tertiary children’s hospital. Participants: Between 1993 and 2006, 877 participants underwent surgery; 712 (81%) were eligible for inclusion; 391 (55%) were included, 321 (45%) excluded. Thirteen percent had bilateral cleft lip and palate (CLP), 40% unilateral CLP, and 47% isolated cleft palate. Intervention: Lip and vomerine flap repair at 3 months of age (BCLP, UCLP) with soft palate closure using radical muscle dissection and retropositioning at a mean age of 6.6 months, range 4 to 23 months, as described and undertaken by Sommerlad. Outcome Measures: Velopharyngeal Composite (VPC) CAPS-A and articulation summary scores derived from analysis using the Cleft Audit Protocol for Speech-Augmented. Results: A VPC-SUM CAPS-A score of “0” was found in 97% reflecting adequate VPF; 73% had no cleft articulation difficulties. The BCLP group had the poorest articulation. Secondary speech surgery rate was 2.6% and 10.7% had fistula repair. Levator muscle quality and degree of retropositioning was associated with speech outcomes related to VPF. 2.6% had current features of VPI. Conclusions: Complete palate closure by around 6 months of age by the surgeon who described the technique led to excellent perceived VPF and very good speech outcomes at age 5, with less speech therapy and secondary speech surgery than commonly reported. These findings serve as a benchmark for the Sommerlad protocol and technique.

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Section: Introductionmentioning

confidence: 99%

Benchmarking Speech, Velopharyngeal Function Outcomes and Surgical Characteristics Following the Sommerlad Protocol and Palate Repair Technique

Baillie

Sell

2020

The Cleft Palate Craniofacial Journal

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“…In PCC-A, ageappropriate simplifications of /s/ and passive cleft speech characteristics marked with diacritics (e.g. audible nasal air leakage, nasal realization and weak articulation) were scored as correct [12,29].…”

Section: Analysis Of Transcriptionsmentioning

confidence: 99%

“…The rate of pharyngeal flaps performed before 5 years of age varied between 0 and 23% [2]. In earlier Swedish studies, 18-40% of the 5-year-olds with UCLP have been reported with moderate to severe hypernasality and 0-17% had a history of secondary VPI surgery [12,[14][15][16].…”

Section: Introductionmentioning

confidence: 98%

“…In the Cleft Care UK study, no score of correct articulation was reported, but almost 15% of children had posterior articulation pattern (backed to velar/uvular) and 10% had non-oral articulation [13]. In the most recent Swedish study, the median of percent consonants correct adjusted for age (PCC-A) was 97% and the median of non-oral errors 0% [12].…”

Section: Introductionmentioning

confidence: 99%

“…At 4-5 years of age, 50-60% of the children with cleft palate ± lip can be expected to have good speech, and the group with isolated cleft palate to have better results than groups with other cleft types [10][11][12]. Two large studies on UCLP speech outcomes at 5 years of age have been published recently: The Cleft Care UK study including 248 children [4], and the Scandcleft trials including 448 children [2,3].…”

Section: Introductionmentioning

confidence: 99%

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Speech in 5-year-olds born with unilateral cleft lip and palate: a Prospective Swedish Intercenter Study

Klintö

Brunnegård

Havstam

et al. 2019

Journal of Plastic Surgery and Hand Surgery

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Studies on the impact of cleft palate surgery on speech with stringent methodology are called for, since we still do not know the best timing or the best method for surgery. The purpose was to report on speech outcome for all Swedish-speaking 5-year-olds born with a non-syndromic unilateral cleft lip and palate (UCLP), in 2008-2010, treated at Sweden's six cleft palate centres, and to compare speech outcomes between centres. Speech was assessed in 57 children with percent consonants correct adjusted for age (PCC-A), based on phonetic transcriptions from audio recordings by five independent judges. Also, hypernasality and perceived velopharyngeal function were assessed. The median PCC-A for all children was 93.9, and medians in the different groups varied from 89.9 to 96.8. In the total group, 9 children (16%) had more than mild hypernasality. Twenty-two children (38.5%) were perceived as having competent/sufficient velopharyngeal function, 25 (44%) as having marginally incompetent/insufficient velopharyngeal function, and 10 children (17.5%) as having incompetent/insufficient velopharyngeal function. Ten children were treated with secondary speech improving surgery and/or fistula surgery. No significant differences among the six groups, with eight to ten children in each group, were found. The results were similar to those in other studies on speech of children with UCLP, but poorer than results in normative data of Swedish-speaking 5-year-olds without UCLP. Indications of differences in frequency of surgical treatment and speech treatment between centres were observed.

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A comparison of orofacial profiles in 5- and 10-year-old Swedish children with and without cleft lip and/or palate

Sundell¹,

Marcusson

2018

Clin Oral Invest

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Speech in 5-Year-Olds With Cleft Palate With or Without Cleft Lip Treated With Primary Palatal Surgery With Muscle Reconstruction According to Sommerlad

Abstract: Speech was poorer in many children with more extensive clefts. Children with CP±L had poorer speech compared to normative data of peers without CP±L, but the results indicated relatively good speech compared to speech of children with CP±L in previous studies.

Cited by 17 publications

References 29 publications

Benchmarking Speech, Velopharyngeal Function Outcomes and Surgical Characteristics Following the Sommerlad Protocol and Palate Repair Technique

Benchmarking Speech, Velopharyngeal Function Outcomes and Surgical Characteristics Following the Sommerlad Protocol and Palate Repair Technique

Speech in 5-year-olds born with unilateral cleft lip and palate: a Prospective Swedish Intercenter Study

A comparison of orofacial profiles in 5- and 10-year-old Swedish children with and without cleft lip and/or palate

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