title: Speech outcomes at age 5 and 10 years in unilateral cleft lip and palate after one-stage palatal repair with minimal incision technique - a longitudinal perspective.
abstract: OBJECTIVE
  To investigate speech outcomes in 5- and 10-year-old children with unilateral cleft lip and palate (UCLP) treated according to minimal incision technique (MIT) - a one-stage palatal method.
  
  
  METHODS
  A retrospective, longitudinal cohort study of a consecutive series of 69 patients born with UCLP, treated with MIT (mean age 13 months) was included. Forty-two children (43%) received a velopharyngeal flap; 12 before 5 years and another 18 before 10 years of age. Cleft speech variables were rated from standardized audio recordings at 5 and 10 years of age, independently by three experienced, external speech-language pathologists, blinded to the material. The prevalences of cleft speech characteristics were determined, and inter- and intra-rater agreement calculated.
  
  
  RESULTS
  More than mild hypernasality, weak pressure consonants and perceived incompetent velopharyngeal function were present in 19-22% of the children at 5 years, but improved to less than 5% at 10 years. However, audible nasal air leakage, prevalent in 23% at 5 years, did not improve by age 10. Thirty percent had frequent or almost always persistent compensatory articulation at 5 years, and 6% at age 10. The general impression of speech improved markedly, from 57% giving a normal impression at 5 years to 89% at 10 years. A high prevalence of distorted/s/was found at both 5 and 10 years of age.
  
  
  CONCLUSIONS
  A high occurrence of speech deviances at 5 years of age after MIT was markedly reduced at 10 years in this study of children with unilateral cleft lip and palate. The high pharyngeal flap rate presumably accounted for the positive speech development.
authors.affiliation: Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Speech Pathology, Karolinska University Hospital, Stockholm, Sweden. Electronic address: jill.nyberg@karolinska.se.
authors.forename: Jill
authors.initials: J
authors.lastname: Nyberg
authors.affiliation: Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Petra
authors.initials: P
authors.lastname: Peterson
authors.affiliation: Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Speech Pathology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Anette
authors.initials: A
authors.lastname: Lohmander
mesh_terms: D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000503:physiopathology / Q000601:surgery*; D002972:Cleft Palate / Q000503:physiopathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D010614:Pharynx / Q000503:physiopathology; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology*; D013064:Speech Disorders / Q000503:physiopathology / Q000601:surgery*; D013070:Speech Therapy / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Longitudinal; One-stage palatal repair; Speech outcome; Unilateral cleft lip and palate