Archives of Plastic Surgery

  • 제51권1호
  • /
  • Pages.80-86
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  • 2024
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Speech Outcomes in 5-Year-Old Korean Children with Bilateral Cleft Lip and Palate

  • Kyung S. Koh (Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Asan Medical Center) ;
  • Seungeun Jung (Division of Speech Pathology and Audiology, Audiology and Speech Pathology Research Institute, Hallym University) ;
  • Bo Ra Park (Department of Rehabilitation Medicine, University of Ulsan, College of Medicine, Asan Medical Center) ;
  • Tae-Suk Oh (Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Asan Medical Center) ;
  • Young Chul Kim (Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Asan Medical Center) ;
  • Seunghee Ha (Division of Speech Pathology and Audiology, Audiology and Speech Pathology Research Institute, Hallym University)
  • 투고 : 2022.07.14
  • 심사 : 2023.08.26
  • 발행 : 2024.01.15
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초록

Background Among the cleft types, bilateral cleft lip and palate (BCLP) generally requires multiple surgical procedures and extended speech therapy to achieve normal speech development. This study aimed to describe speech outcomes in 5-year-old Korean children with BCLP and examine whether normal speech could be achieved before starting school. Methods The retrospective study analyzed 52 children with complete BCLP who underwent primary palatal surgery at a tertiary medical center. Three speech-language pathologists made perceptual judgments on recordings from a speech follow-up assessment of 5-year-old children. They assessed the children's speech in terms of articulation, speech intelligibility, resonance, and voice using the Cleft Audit Protocol for Speech-Augmented-Korean Modification. Results The results indicated that at the age of five, 65 to 70% of children with BCLP presented articulation and resonance within normal or acceptable ranges. Further, seven children with BCLP (13.5%) needed both additional speech therapy and palatal surgery for persistent velopharyngeal insufficiency and speech problems even at the age of five. Conclusion This study confirmed that routine follow-up speech assessments are essential as a substantial number of children with BCLP require secondary surgical procedures and extended speech therapy to achieve normal speech development.

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참고문헌

  1. Choa RM, Slator R, Jeremy A, et al. Identifying the effect of cleft type, deprivation and ethnicity on speech and dental outcomes in UK cleft patients: a multi-centred study. J Plast Reconstr Aesthet Surg 2014;67(12):1637-1643 https://doi.org/10.1016/j.bjps.2014.07.018
  2. Hardin-Jones MA, Jones DL. Speech production of preschoolers with cleft palate. Cleft Palate Craniofac J 2005;42(01):7-13 https://doi.org/10.1597/03-134.1
  3. Persson C, Elander A, Lohmander-Agerskov A, Soderpalm E. Speech outcomes in isolated cleft palate: impact of cleft extent and additional malformations. Cleft Palate Craniofac J 2002;39(04):397-408 https://doi.org/10.1597/1545-1569_2002_039_0397_soiicp_2.0.co_2
  4. Medina J, Fitzsimons K, Russell C, et al. Cleft Registry and Audit NEtwork Database 2020 annual report [Internet]. London: Cleft Registry and Audit NEtwork; 2020 Accessed June 13, 2022 at: https://www.crane-database.org.uk/content/uploads/2020/12/CRANE-2020-Annual-Report_V1.pdf
  5. Baillie L, Sell D. Benchmarking speech, velopharyngeal function outcomes and surgical characteristics following the sommerlad protocol and palate repair technique. Cleft Palate Craniofac J 2020;57(10):1197-1215 https://doi.org/10.1177/1055665620923925
  6. Ha S, Koh KS, Moon H, Jung S, Oh TS. Clinical outcomes of primary palatal surgery in children with nonsyndromic cleft palate with and without lip. BioMed Res Int 2015;2015:185459
  7. Lohmander A, Friede H, Lilja J. Long-term, longitudinal follow-up of individuals with unilateral cleft lip and palate after the Gothenburg primary early veloplasty and delayed hard palate closure protocol: speech outcome. Cleft Palate Craniofac J 2012;49(06):657-671 https://doi.org/10.1597/11-085
  8. Sullivan SR, Marrinan EM, LaBrie RA, Rogers GF, Mulliken JB. Palatoplasty outcomes in nonsyndromic patients with cleft palate: a 29-year assessment of one surgeon's experience. J Craniofac Surg 2009;20(Suppl 1):612-616 https://doi.org/10.1097/SCS.0b013e318192801b
  9. Lohmander A. Surgical intervention and speech outcomes in cleft lip and palate. In: Howard S, Lohmander A, eds. Cleft Palate Speech: Assessment and Intervention. Chichester: Wiley-Blackwell; 2011:55-85
  10. Shaw W, Semb G. The Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 11. What next? J Plast Surg Hand Surg 2017;51(01):88-93 https://doi.org/10.1080/2000656X.2016.1254644
  11. Slator R, Perisanidou LI, Waylen A, Sandy J, Ness A, Wills AK. Range and timing of surgery, and surgical sequences used, in primary repair of complete unilateral cleft lip and palate: The Cleft Care UK study. Orthod Craniofac Res 2020;23(02):166-173 https://doi.org/10.1111/ocr.12355
  12. Lohmander A, Persson C, Willadsen E, et al. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 4. Speech outcomes in 5-year-olds - velopharyngeal competency and hypernasality. J Plast Surg Hand Surg 2017;51(01):27-37 https://doi.org/10.1080/2000656X.2016.1254645
  13. Willadsen E, Lohmander A, Persson C, et al. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 5. Speech outcomes in 5-year-olds - consonant proficiency and errors. J Plast Surg Hand Surg 2017;51(01):38-51 https://doi.org/10.1080/2000656X.2016.1254647
  14. Persson C, Pedersen NH, Hayden C, et al. Scandcleft Project Trial 3: comparison of speech outcomes in relation to sequence in 2-stage palatal repair procedures in 5-year-olds with unilateral cleft lip and palate. Cleft Palate Craniofac J 2020;57(03):352-363 https://doi.org/10.1177/1055665619896637
  15. Kuehn DP, Moller KT. Speech and language issues in the cleft palate population: the state of the art. Cleft Palate Craniofac J 2000;37:1-35 https://doi.org/10.1597/1545-1569_2000_037_0348_saliit_2.3.co_2
  16. Brunnegard K, Lohmander A. A cross-sectional study of speech in 10-year-old children with cleft palate: results and issues of rater reliability. Cleft Palate Craniofac J 2007;44(01):33-44 https://doi.org/10.1597/05-164
  17. Chapman KL, Baylis A, Trost-Cardamone J, et al. The Americleft Speech Project: a training and reliability study. Cleft Palate Craniofac J 2016;53(01):93-108 https://doi.org/10.1597/14-027
  18. Ha S. The Cleft Audit Protocol for Speech-Augmented-Korean modification: reliability test [in Korean]. Commun Sci Disord 2018;23:703-712 https://doi.org/10.12963/csd.18527
  19. Sell D, Mildinhall S, Albery L, Wills AK, Sandy JR, Ness AR. The Cleft Care UK study. Part 4: perceptual speech outcomes. Orthod Craniofac Res 2015;18(Suppl 2):36-46 https://doi.org/10.1111/ocr.12112
  20. Kim Y, Shin M. Urimal Test of Articulation and Phonology (U-TAP). Seoul: Hakjisa; 2004
  21. John A, Sell D, Sweeney T, Harding-Bell A, Williams A. The cleft audit protocol for speech-augmented: a validated and reliable measure for auditing cleft speech. Cleft Palate Craniofac J 2006;43(03):272-288 https://doi.org/10.1597/04-141.1
  22. Streiner DL, Norman GR, Cairney J. Health Measurement Scales: A Practical Guide to Their Development and Use. 5th ed. New York: Oxford University Press; 2015
  23. Karling J, Larson O, Leanderson R, Henningsson G. Speech in unilateral and bilateral cleft palate patients from Stockholm. Cleft Palate Craniofac J 1993;30(01):73-77 https://doi.org/10.1597/1545-1569_1993_030_0073_siuabc_2.3.co_2
  24. Peryer H, Slator R, Thomson J, Richard B. The method of surgical lip repair affects speech outcomes in children with bilateral cleft lip and palate. Cleft Palate Craniofac J 2021;58(04):419-428 https://doi.org/10.1177/1055665620956872
  25. Lohmander-Agerskov A, Friede H, Lilja J, Soderpalm E. Delayed closure of the hard palate: a comparison of speech in children with open and functionally closed residual clefts. Scand J Plast Reconstr Surg Hand Surg 1996;30(02):121-127 https://doi.org/10.3109/02844319609056393
  26. Lohmander A, Persson C. A longitudinal study of speech production in Swedish children with unilateral cleft lip and palate and two-stage palatal repair. Cleft Palate Craniofac J 2008;45(01):32-41 https://doi.org/10.1597/06-123.1
  27. Shriberg LD, Kent RD, Karlsson HB, McSweeny JL, Nadler CJ, Brown RL. A diagnostic marker for speech delay associated with otitis media with effusion: backing of obstruents. Clin Linguist Phon 2003;17(07):529-547 https://doi.org/10.1080/0269920031000138132
  28. Grunwell P, Brondsted K, Henningsson G, et al. A six-centre international study of the outcome of treatment in patients with clefts of the lip and palate: the results of a cross-linguistic investigation of cleft palate speech. Scand J Plast Reconstr Surg Hand Surg 2000;34(03):219-229 https://doi.org/10.1080/02844310050159792