Speech outcomes following Sommerlad primary palatoplasty: Results of the Ghent University Hospital

Abstract

Patients still present with both obligatory and compensatory speech disorders following Sommerlad's palatoplasty. In the future, a Dutch speech assessment protocol will be developed in order to standardize follow-up of these patients and to allow for within-center and inter-center comparisons.

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

“…Percent consonant correct (PCC) was used to report articulation outcomes, with 88.7 PCC reported for this group. Bruneel et al (2018) also reported outcomes in a small cohort (n = 16), with a similar mean age of palate repair at 12 months of age to the Klinto et al (2018) study, although with a much wider range of 7 to 25 months. Fifty-six percent were reported to have acceptable speech at age 5.…”

“…When comparing these outcomes to those studies reporting the Sommerlad technique with a robust speech methodology at 5 years of age (Cairns et al, 2014;Klinto et al, 2018;Bruneel et al, 2018;Mapar et al, 2019;Nyberg et al, 2018) in 4 of the 5 studies, surgery was undertaken between a mean age of 11.3 to 13.6 months, compared with a mean age of 6.6 months in this study. Only the study by Cairns et al (2014) had a similar age at palate repair to this study.…”

“…In trying to make comparisons with the current study, Appendix 1 shows how the languages and speech samples are different. For example, Klinto et al 2018used single words for their analysis, although collected a wider speech sample including sentence repetition and story retelling; Nyberg et al 2018used sentence repetition; the current study and Cairns et al 2014used rote speech and sentence repetition; the Bruneel et al (2018) study in Belgium used spontaneous speech, rote speech, syllable, and sentence repetition. Another very significant issue is that authors often summarize and report data differently making comparison of outcomes difficult (Sell, 2005).…”

“…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). Five studies used robust speech methodologies with varied speech results for 5-year-old children, tabulated in Appendix 1 (Cairns et al, 2014; Klinto et al, 2018; Bruneel et al, 2018; Nyberg et al, 2018; Mapar et al, 2019). These studies are characterized by speech recordings, the use of listeners external to the team, validated outcome measures, and reports of listener reliability and agreement.…”