Interdisciplinary cleft care outcomes in adults (Van der Straeten et al., 2023)

Purpose: Individuals born with a cleft palate with or without a cleft lip (CP ± L) often experience functional, aesthetic, and psychosocial consequences well into adulthood. This study aimed to investigate outcomes of speech and health-related quality of life (HRQoL) in adults with a CP ± L who received interdisciplinary cleft care at the Ghent University Hospital using valid, reliable, and condition-specific instruments.Method: Thirteen Belgian Dutch-speaking participants with a CP ± L with a mean age of 25.4 years (SD = 5.1, range: 20–33 years) and an age- and gender-matched control group of 13 participants without a CP ± L with a mean age of 25.2 years (SD = 4.8, range: 20–32 years) were included in this study. Speech characteristics were evaluated perceptually and instrumentally. HRQoL was assessed through standardized patient-reported outcome measures. Outcomes were compared with those of the control group and to normative data where available.Results: Participants with a CP ± L in this sample demonstrated significantly lower speech acceptability (p < .001) and higher rates of hypernasality (p = .015) and nasal turbulence (p = .005) than the control group. They showed significantly higher satisfaction with appearance of the cleft scar compared with norms of adults with a CP ± L (p = .047). No other differences in speech characteristics, sociodemographics, or HRQoL were found between participants with and without a CP ± L.Conclusions: The reduced speech acceptability and the presence of resonance and nasal airflow disorders may indicate the need for standardized long-term outcome measurement and interdisciplinary follow-up for speech characteristics and velopharyngeal insufficiency in young and middle adulthood in future clinical practice. Additional research is necessary to further substantiate these findings and to determine predictors for these continuing complications in adults with a CP ± L.Supplemental Material S1. Post-hoc power analysis for t-tests (means), Wilcoxon-Mann-Whitney test (two groups), using G*Power (Faul et al., 2007).Van der Straeten, C., Verbeke, J., Alighieri, C., Bettens, K., Van Beveren, E., Bruneel, L., & Van Lierde, K. (2023). Treatment outcomes of interdisciplinary care on speech and health-related quality of life outcomes in adults with cleft palate. American Journal of Speech-Language Pathology, 32(6), 2654–2675. https://doi.org/10.1044/2023_AJSLP-23-00024

研究目的：患有裂腭症（CP）伴随或不伴随唇裂（±L）的个体，常在成年后遭受功能、美学和心理社会方面的不良后果。本研究旨在探究在根特大学医院接受跨学科裂腭症护理的CP±L成年人的言语及健康相关生活质量（HRQoL）结果，并使用有效、可靠且针对特定条件的工具进行评估。研究方法：纳入了13名平均年龄为25.4岁（标准差=5.1，范围：20–33岁）的比利时荷兰语讲者，他们患有CP±L，并配备了13名年龄和性别相匹配的对照组参与者，平均年龄为25.2岁（标准差=4.8，范围：20–32岁），均无CP±L。通过感知和仪器方法评估言语特征。通过标准化的患者报告结果测量方法评估HRQoL。结果与对照组和可用的规范性数据进行了比较。结果：本样本中CP±L患者表现出显著降低的言语可接受度（p < .001）、更高的过度鼻音率（p = .015）和鼻部湍流率（p = .005），与对照组相比。他们与CP±L成年人的正常标准相比，对裂痕外观的满意度显著更高（p = .047）。在言语特征、社会人口统计学或HRQoL方面，未发现CP±L患者与无CP±L患者之间存在其他差异。结论：降低的言语可接受度以及共鸣和鼻部气流障碍的存在可能表明，在未来的临床实践中，需要对年轻和中年CP±L患者的言语特征和腭咽不足进行标准化的长期结果测量和多学科跟踪。需要进一步的研究来进一步证实这些发现，并确定这些持续并发症的预测因素。补充材料S1：使用G*Power（Faul等，2007年）进行的t检验（均值）、Wilcoxon-Mann-Whitney检验（两组）的后验功效分析。Van der Straeten, C., Verbeke, J., Alighieri, C., Bettens, K., Van Beveren, E., Bruneel, L., & Van Lierde, K. (2023). 跨学科护理对CP成年人言语及健康相关生活质量结果的治疗效果。美国言语-语言病理学杂志，32(6)，2654–2675. https://doi.org/10.1044/2023_AJSLP-23-00024