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

<b>Purpose:</b> 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.<b>Method:</b> Thirteen Belgian Dutch-speaking participants with a CP ± L with a mean age of 25.4 years (<i>SD</i> = 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 (<i>SD</i> = 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.<b>Results:</b> Participants with a CP ± L in this sample demonstrated significantly lower speech acceptability (<i>p</i> &lt; .001) and higher rates of hypernasality (<i>p</i> = .015) and nasal turbulence (<i>p</i> = .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 (<i>p</i> = .047). No other differences in speech characteristics, sociodemographics, or HRQoL were found between participants with and without a CP ± L.<b>Conclusions:</b> 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.<b>Supplemental Material S1.</b> 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., &amp; Van Lierde, K. (2023). Treatment outcomes of interdisciplinary care on speech and health-related quality of life outcomes in adults with cleft palate. <i>American Journal of Speech-Language Pathology, 32</i>(6), 2654–2675. https://doi.org/10.1044/2023_AJSLP-23-00024

**研究目的：** 先天性伴或不伴唇裂的腭裂（Cleft Palate with or without a Cleft Lip, CP ± L）患者常于成年后仍存在功能、美观及社会心理层面的不良影响。本研究旨在采用经过验证、信效度良好且针对特定病症的评估工具，探究在根特大学医院接受跨学科腭裂诊疗的伴CP ± L成人的言语结局与健康相关生活质量（Health-Related Quality of Life, HRQoL）。
**研究方法：** 本研究纳入13名比利时荷兰语使用者，均为伴CP ± L的成人，平均年龄25.4岁（标准差（Standard Deviation, SD）=5.1，年龄范围20~33岁）；同时设置年龄与性别匹配的对照组，包含13名无CP ± L的成人，平均年龄25.2岁（SD=4.8，年龄范围20~32岁）。研究通过感知评估与仪器检测两种方式对言语特征进行评价，采用标准化患者报告结局量表评估HRQoL，并将研究结果与对照组及可获取的常模数据进行对比。
**研究结果：** 本样本中的伴CP ± L受试者，其言语可接受度显著低于对照组（*p* < 0.001），且高鼻音（*p* = 0.015）与鼻腔湍流（*p* = 0.005）发生率更高。相较于伴CP ± L成人的常模数据，该组受试者对腭裂瘢痕外观的满意度显著更高（*p* = 0.047）。其余言语特征、社会人口学特征及HRQoL在两组受试者间未发现显著差异。
**研究结论：** 言语可接受度降低以及共振异常与鼻腔气流紊乱，提示未来临床实践中需针对年轻及中年成年伴CP ± L患者，开展标准化的长期结局评估，并对其言语特征及腭咽功能不全进行跨学科随访。此外，还需开展更多研究以进一步验证本研究结果，并明确伴CP ± L成人此类持续性并发症的预测因素。
**补充材料S1：** 采用G*Power（Faul等，2007）完成的t检验（均值比较）、威尔科克森-曼-惠特尼检验（两组比较）的事后功效分析。
Van der Straeten, C., Verbeke, J., Alighieri, C., Bettens, K., Van Beveren, E., Bruneel, L., & Van Lierde, K. (2023). 腭裂患者跨学科诊疗的言语与健康相关生活质量结局. 《美国言语语言病理学期刊》, 32(6), 2654–2675. https://doi.org/10.1044/2023_AJSLP-23-00024