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Your search keyword '"Velopharyngeal incompetence (VPI)"' showing total 4 results
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4 results on '"Velopharyngeal incompetence (VPI)"'

1. Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: Speech proficiency at 10 years of age

Author

E. Willadsen, L. D. Jørgensen, S. Alaluusua, N. H. Pedersen, J. B. Nielsen, E. Hölttä, Ø. Hide, C. Hayden, C. Havstam, I. L. Hammarström, J. Davies, M. Boers, H. S. Andersen, R. Aukner, D. Jackson Morris, S. F. Nielsen, G. Semb, A. Lohmander, and C. Persson

Subjects
consonant proficiency, palatal surgical protocols, randomized controlled trial (RCT), unilateral cleft lip and palate (UCLP), velopharyngeal competence (VPC) velopharyngeal incompetence (VPI), Linguistics and Language, Velopharyngeal incompetence(VPI, Randomizedcontrolled trial (RCT), Velopharyngeal competence (VPC), Other Medical Sciences not elsewhere specified, Unilateral cleft lip and palate (UCLP), Language and Linguistics, Consonant proficiency, Speech and Hearing, Övrig annan medicin och hälsovetenskap, Velopharyngeal incompetence (VPI), Unilateralcleft lip and palate (UCLP), Randomized controlled trial (RCT), Palatal surgical protocols
Abstract

Background & Aim: To assess consonant proficiency and velopharyngeal function in 10-year-old children born with unilateral cleft lip and palate (UCLP) within the Scandcleft project.Methods & Procedures: Three parallel group, randomized, clinical trials were undertaken as an international multicentre study by nine cleft teams in five countries. Three different surgical protocols for primary palate repair (Arm B–Lip and soft palate closure at 3–4 months, hard palate closure at 36 months, Arm C–Lip closure at 3–4 months, hard and soft palate closure at 12 months, and Arm D–Lip closure at 3–4 months combined with a single-layer closure of the hard palate using a vomer flap, soft palate closure at 12 months) were tested against a common procedure (Arm A–Lip and soft palate closure at 3–4 months followed by hard palate closure at 12 months) in the total cohort of 431 children born with a non-syndromic UCLP. Speech audio and video recordings of 399 children were available and perceptually analysed. Percentage of consonants correct (PCC) from a naming test, an overall rating of velopharyngeal competence (VPC) (VPC-Rate), and a composite measure (VPC-Sum) were reported.Outcomes & Results: The mean levels of consonant proficiency (PCC score) in the trial arms were 86–92% and between 58% and 83% of the children had VPC (VPC-Sum). Only 50–73% of the participants had a consonant proficiency level with their peers. Girls performed better throughout. Long delay of the hard palate repair (Arm B) indicated lower PCC and simultaneous hard and soft palate closure higher (Arm C). However, the proportion of participants with primary VPC (not including velopharyngeal surgeries) was highest in Arm B (68%) and lowest in Arm C (47%).Conclusions & Implications: The speech outcome in terms of PCC and VPC was low across the trials. The different protocols had their pros and cons and there is no obvious evidence to recommend any of the protocols as superior. Aspects other than primary surgical method, such as time after velopharyngeal surgery, surgical experience, hearing level, language difficulties and speech therapy, need to be thoroughly reviewed for a better understanding of what has affected speech outcome at 10 years.

Published
2022

3. Submucous Cleft Palate: A Systematic Review of Surgical Management Based on Perceptual and Instrumental Analysis.

Author

Gilleard, Onur, Sell, Debbie, Ghanem, Ali, Tavsanoglu, Yasemin, Birch, Malcolm, and Sommerlad, Brian

Subjects
CLEFT palate, COMPARATIVE studies, DATABASES, DIAGNOSTIC imaging, MEDICAL information storage & retrieval systems, MEDLINE, META-analysis, SURGICAL complications, SYSTEMATIC reviews, GENOMICS, RANDOMIZED controlled trials, SURGERY
Abstract

Objective: Submucous cleft palate (SMCP) is a congenital condition associated with abnormal development of the soft palate musculature. In a proportion of cases, this results in velopharyngeal insufficiency (VPI), the treatment for which includes pharyngeal flap surgery, pharyngoplasty, and palate reconstruction. The aim of this paper is to determine whether there is superiority of one or more types of surgical procedure over the others in improving speech in patients with VPI secondary to SMCP. Methodology: Nine databases, including MEDLINE and EMBASE, were searched between inception and January 2013 to identify articles published relating to the surgical management of SMCP. Only studies that reported outcome measures for postoperative speech were included in the systematic review. Results: Twenty-six studies analyzing the outcomes of surgery for VPI in patients with SMCP met the inclusion criteria. In these studies, speech outcomes were measured either in a binary fashion (i.e., normal speech or evidence of VPI) or using scales of VPI severity. Of the 26 studies, only two utilized blinded speech assessment, and 12 included both preoperative and postoperative speech assessment. Conclusions: The review found little evidence to support any specific surgical intervention. This is in large part due to the inclusion of mixed etiologies within study populations and the lack of unbiased validated preoperative and postoperative speech assessment. Further methodologically rigorous studies need to be conducted to provide a secure evidence base for the surgical management of SMCP. [ABSTRACT FROM AUTHOR]

Published
2014
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4. Submucous cleft palate: a systematic review of surgical management based on perceptual and instrumental analysis.

Author

Gilleard O, Sell D, Ghanem AM, Tavsanoglu Y, Birch M, and Sommerlad B

Subjects
Humans, Mouth Mucosa surgery, Surgical Instruments, Cleft Palate surgery, Palate, Soft surgery, Velopharyngeal Insufficiency surgery
Abstract

Objective : Submucous cleft palate (SMCP) is a congenital condition associated with abnormal development of the soft palate musculature. In a proportion of cases, this results in velopharyngeal insufficiency (VPI), the treatment for which includes pharyngeal flap surgery, pharyngoplasty, and palate reconstruction. The aim of this paper is to determine whether there is superiority of one or more types of surgical procedure over the others in improving speech in patients with VPI secondary to SMCP. Methodology : Nine databases, including MEDLINE and EMBASE, were searched between inception and January 2013 to identify articles published relating to the surgical management of SMCP. Only studies that reported outcome measures for postoperative speech were included in the systematic review. Results : Twenty-six studies analyzing the outcomes of surgery for VPI in patients with SMCP met the inclusion criteria. In these studies, speech outcomes were measured either in a binary fashion (i.e., normal speech or evidence of VPI) or using scales of VPI severity. Of the 26 studies, only two utilized blinded speech assessment, and 12 included both preoperative and postoperative speech assessment. Conclusions : The review found little evidence to support any specific surgical intervention. This is in large part due to the inclusion of mixed etiologies within study populations and the lack of unbiased validated preoperative and postoperative speech assessment. Further methodologically rigorous studies need to be conducted to provide a secure evidence base for the surgical management of SMCP.

Published
2014
Full Text
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