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Inter-centre comparison of data on surgery and speech outcomes at 5 years of age based on the Swedish quality registry for patients born with cleft palate with or without cleft lip

Klintö, Kristina LU orcid ; Eriksson, Marie ; Abdiu, Avni ; Brunnegård, Karin ; Cajander, Jenny LU ; Hagberg, Emilie ; Hakelius, Malin ; Havstam, Christina ; Mark, Hans and Okhiria, Åsa , et al. (2022) In BMC Pediatrics 22(1).
Abstract

BACKGROUND: The objective of the Swedish cleft lip and palate registry (CLP registry) is to promote quality control, research and improvement of treatment, by the comparison of long-term results. The aim was to compare data from the CLP registry among the six treatment centres, regarding data on surgery and speech outcomes at 5 years of age.

METHODS: The participants were 430 children born in Sweden from 2009 to 2014, with cleft palate with or without cleft lip and without known syndromes and/or additional malformations. The number of primary and secondary palatal surgeries up to 5 years of age, timing of the last primary palatal surgery, percentage consonants correct, percentage non-oral speech errors and perceived velopharyngeal... (More)

BACKGROUND: The objective of the Swedish cleft lip and palate registry (CLP registry) is to promote quality control, research and improvement of treatment, by the comparison of long-term results. The aim was to compare data from the CLP registry among the six treatment centres, regarding data on surgery and speech outcomes at 5 years of age.

METHODS: The participants were 430 children born in Sweden from 2009 to 2014, with cleft palate with or without cleft lip and without known syndromes and/or additional malformations. The number of primary and secondary palatal surgeries up to 5 years of age, timing of the last primary palatal surgery, percentage consonants correct, percentage non-oral speech errors and perceived velopharyngeal competence at 5 years were assessed. Multivariable binary logistic regression adjusted for sex and cleft type was used to compare results between the six centres.

RESULTS: At one centre (centre 4), the palate was closed in one to three stages, and at the remaining centres in one or two stages. At centre 4, more children underwent a higher number of palatal surgeries, and the last primary palatal surgery was performed at a higher age. Children in centre 4 were also less likely to achieve ≥86% correct consonants (OR = 0.169, P = < 0.001), have no non-oral speech errors (OR = 0.347, P = < 0.001), or have competent or marginally incompetent velopharyngeal competence (OR = 0.244, P = < 0.001), compared to the average results of the other centres. No clear association between patient volume and speech outcome was observed.

CONCLUSIONS: The results indicated the risk of a negative speech result if the last primary palatal surgery was performed after 25 months of age. Whether the cleft in the palate was closed in one or two stages did not affect speech outcome. The Swedish CLP registry can be used for open comparisons of treatment results to provide the basis for improvements of treatment methods. If deviating negative results are seen consistently at one centre, this information should be acted upon by further investigation and analysis, making changes to the treatment protocol as needed.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Child, Child, Preschool, Cleft Lip/complications, Cleft Palate/complications, Humans, Registries, Speech, Sweden, Treatment Outcome
in
BMC Pediatrics
volume
22
issue
1
article number
303
publisher
BioMed Central (BMC)
external identifiers
  • pmid:35606744
  • scopus:85130449677
ISSN
1471-2431
DOI
10.1186/s12887-022-03367-2
language
English
LU publication?
yes
id
b379afa5-e31b-4f26-b643-85618efd6669
date added to LUP
2022-07-27 11:51:47
date last changed
2024-06-13 18:07:00
@article{b379afa5-e31b-4f26-b643-85618efd6669,
  abstract     = {{<p>BACKGROUND: The objective of the Swedish cleft lip and palate registry (CLP registry) is to promote quality control, research and improvement of treatment, by the comparison of long-term results. The aim was to compare data from the CLP registry among the six treatment centres, regarding data on surgery and speech outcomes at 5 years of age.</p><p>METHODS: The participants were 430 children born in Sweden from 2009 to 2014, with cleft palate with or without cleft lip and without known syndromes and/or additional malformations. The number of primary and secondary palatal surgeries up to 5 years of age, timing of the last primary palatal surgery, percentage consonants correct, percentage non-oral speech errors and perceived velopharyngeal competence at 5 years were assessed. Multivariable binary logistic regression adjusted for sex and cleft type was used to compare results between the six centres.</p><p>RESULTS: At one centre (centre 4), the palate was closed in one to three stages, and at the remaining centres in one or two stages. At centre 4, more children underwent a higher number of palatal surgeries, and the last primary palatal surgery was performed at a higher age. Children in centre 4 were also less likely to achieve ≥86% correct consonants (OR = 0.169, P = &lt; 0.001), have no non-oral speech errors (OR = 0.347, P = &lt; 0.001), or have competent or marginally incompetent velopharyngeal competence (OR = 0.244, P = &lt; 0.001), compared to the average results of the other centres. No clear association between patient volume and speech outcome was observed.</p><p>CONCLUSIONS: The results indicated the risk of a negative speech result if the last primary palatal surgery was performed after 25 months of age. Whether the cleft in the palate was closed in one or two stages did not affect speech outcome. The Swedish CLP registry can be used for open comparisons of treatment results to provide the basis for improvements of treatment methods. If deviating negative results are seen consistently at one centre, this information should be acted upon by further investigation and analysis, making changes to the treatment protocol as needed.</p>}},
  author       = {{Klintö, Kristina and Eriksson, Marie and Abdiu, Avni and Brunnegård, Karin and Cajander, Jenny and Hagberg, Emilie and Hakelius, Malin and Havstam, Christina and Mark, Hans and Okhiria, Åsa and Peterson, Petra and Svensson, Kristina and Becker, Magnus}},
  issn         = {{1471-2431}},
  keywords     = {{Child; Child, Preschool; Cleft Lip/complications; Cleft Palate/complications; Humans; Registries; Speech; Sweden; Treatment Outcome}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Pediatrics}},
  title        = {{Inter-centre comparison of data on surgery and speech outcomes at 5 years of age based on the Swedish quality registry for patients born with cleft palate with or without cleft lip}},
  url          = {{http://dx.doi.org/10.1186/s12887-022-03367-2}},
  doi          = {{10.1186/s12887-022-03367-2}},
  volume       = {{22}},
  year         = {{2022}},
}