Influence of Infant Cleft Dimensions on Velopharyngeal Function in 5-Year-Old Danish Children Born With Unilateral Cleft Lip and Palate
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Influence of Infant Cleft Dimensions on Velopharyngeal Function in 5-Year-Old Danish Children Born With Unilateral Cleft Lip and Palate. / Botticelli, Susanna; Küseler, Annelise; Mølsted, Kirsten ; Søgaard Andersen, Helene ; Boers, Maria; Schops, Antje; Emborg, Berit Kildegaard; Kisling-Møller, Mia; Klit Petersen, Thomas ; Andersen, Mikael; Willadsen, Elisabeth.
In: The Cleft Palate-Craniofacial Journal, Vol. 57, No. 4, 2020, p. 420-429.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Influence of Infant Cleft Dimensions on Velopharyngeal Function in 5-Year-Old Danish Children Born With Unilateral Cleft Lip and Palate
AU - Botticelli, Susanna
AU - Küseler, Annelise
AU - Mølsted, Kirsten
AU - Søgaard Andersen, Helene
AU - Boers, Maria
AU - Schops, Antje
AU - Emborg, Berit Kildegaard
AU - Kisling-Møller, Mia
AU - Klit Petersen, Thomas
AU - Andersen, Mikael
AU - Willadsen, Elisabeth
PY - 2020
Y1 - 2020
N2 - Aim:To examine the association of cleft severity at infancy and velopharyngeal competence in preschool children with unilateral cleft lip and palate operated with early or delayed hard palate repair.Design:Subgroup analysis within a multicenter randomized controlled trial of primary surgery (Scandcleft).Setting:Tertiary health care. One surgical center.Patients and Methods:One hundred twenty-five infants received cheilo-rhinoplasty and soft palate repair at age 3 to 4 months and were randomized to hard palate closure at age 12 or 36 months. Cleft size and cleft morphology were measured 3 dimensionally on digital models, obtained by laser surface scanning of preoperative plaster models (mean age: 1.8 months).Main outcome measurements:Velopharyngeal competence (VPC) and hypernasality assessed from a naming test (VPC-Sum) and connected speech (VPC-Rate). In both scales, higher scores indicated a more severe velopharyngeal insufficiency.Results:No difference between surgical groups was shown. A low positive correlation was found between posterior cleft width and VPC-Rate (Spearman = .23; P = .025). The role of the covariate “cleft size at tuberosity level” was confirmed in an ordinal logistic regression model (odds ratio [OR] = 1.17; 95% confidence interval [CI]:1.01-1.35). A low negative correlation was shown between anteroposterior palatal length and VPC-Sum (Spearman = −.27; P = .004) and confirmed by the pooled scores VPC-Pooled (OR = 0.82; 95% CI: 0.69-0.98) and VPC-Dichotomic (OR = 0.82; 95% CI: 0.68-0.99).Conclusions:Posterior cleft dimensions can be a modest indicator for the prognosis of velopharyngeal function at age 5 years, when the soft palate is closed first, independently on the timing of hard palate repair. Antero-posterior palatal length seems to protect from velopharyngeal insufficiency and hypernasality. However, the association found was significant but low.Keywords nonsyndromic clefting, speech development, velopharyngeal function, hard palate, surgical technique
AB - Aim:To examine the association of cleft severity at infancy and velopharyngeal competence in preschool children with unilateral cleft lip and palate operated with early or delayed hard palate repair.Design:Subgroup analysis within a multicenter randomized controlled trial of primary surgery (Scandcleft).Setting:Tertiary health care. One surgical center.Patients and Methods:One hundred twenty-five infants received cheilo-rhinoplasty and soft palate repair at age 3 to 4 months and were randomized to hard palate closure at age 12 or 36 months. Cleft size and cleft morphology were measured 3 dimensionally on digital models, obtained by laser surface scanning of preoperative plaster models (mean age: 1.8 months).Main outcome measurements:Velopharyngeal competence (VPC) and hypernasality assessed from a naming test (VPC-Sum) and connected speech (VPC-Rate). In both scales, higher scores indicated a more severe velopharyngeal insufficiency.Results:No difference between surgical groups was shown. A low positive correlation was found between posterior cleft width and VPC-Rate (Spearman = .23; P = .025). The role of the covariate “cleft size at tuberosity level” was confirmed in an ordinal logistic regression model (odds ratio [OR] = 1.17; 95% confidence interval [CI]:1.01-1.35). A low negative correlation was shown between anteroposterior palatal length and VPC-Sum (Spearman = −.27; P = .004) and confirmed by the pooled scores VPC-Pooled (OR = 0.82; 95% CI: 0.69-0.98) and VPC-Dichotomic (OR = 0.82; 95% CI: 0.68-0.99).Conclusions:Posterior cleft dimensions can be a modest indicator for the prognosis of velopharyngeal function at age 5 years, when the soft palate is closed first, independently on the timing of hard palate repair. Antero-posterior palatal length seems to protect from velopharyngeal insufficiency and hypernasality. However, the association found was significant but low.Keywords nonsyndromic clefting, speech development, velopharyngeal function, hard palate, surgical technique
U2 - 10.1177/1055665619874143
DO - 10.1177/1055665619874143
M3 - Journal article
C2 - 31505955
VL - 57
SP - 420
EP - 429
JO - Cleft Palate - Craniofacial Journal
JF - Cleft Palate - Craniofacial Journal
SN - 1055-6656
IS - 4
ER -
ID: 226222656