{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:52:34Z","timestamp":1787820754175,"version":"build-2784847793"},"reference-count":26,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T00:00:00Z","timestamp":1695859200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPHS"],"abstract":"<jats:p>\n\n\n\nAdvancement of the maxilla may increase the distance between the soft palate and the posterior pharyngeal wall in patients with cleft lip and palate, implying a risk of velopharyngeal dysfunction. The aim was to evaluate long-term speech outcome in a consecutive series of patients treated with distraction osteogenesis (DO). Fourteen out of the 16 patients agreed to participate. A long-term speech follow-up was performed 1.5\u00a0to 13.5 years after DO. For two participants, audio recordings before DO were missing, and for another one, it was incomplete. The percentage of consonants correct (PCC) based on phonetic transcription and perceived velopharyngeal competence rated on a three-point scale were assessed before and after DO by three independent judges, based on audio recordings of reading of standardised sentences. Also, the participants were asked how they perceived their speech after DO. Changes in PCC were insignificant. Four participants perceived deteriorated speech related to DO. In two cases, the subjective deterioration did not correlate to results from perceptual assessment. In two others, the subjective deterioration correlated with the perceptual assessment, and the velopharyngeal function was judged as being incompetent after DO. After secondary velopharyngeal surgery, velopharyngeal function improved to competent in one case and marginally incompetent in the other. The results need to be interpreted with caution due to methodological limitations but indicate that some patients develop deteriorated velopharyngeal function after DO. The impact on articulation needs to be further explored. It is important that patients are informed before treatment of the risk of velopharyngeal dysfunction after DO.\n\n\n\n<\/jats:p>","DOI":"10.2340\/jphs.v58.12308","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T08:10:10Z","timestamp":1695888610000},"page":"110-114","source":"Crossref","is-referenced-by-count":3,"title":["Long-term speech outcome after anterior distraction osteogenesis of the maxilla in patients with cleft lip and palate"],"prefix":"10.2340","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7044-9386","authenticated-orcid":false,"given":"Kristina","family":"Klint\u00f6","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Svensson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Paulina","family":"Wiedel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2023,9,28]]},"reference":[{"key":"39039","doi-asserted-by":"crossref","unstructured":"Klint\u00f6 K, Eriksson M, Abdiu A, Brunneg\u00e5rd K, et al. 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. BMC Pediatr. 2022;22:303. https:\/\/doi.org\/10.1186\/s12887-022-03367-2","DOI":"10.1186\/s12887-022-03367-2"},{"key":"39040","doi-asserted-by":"crossref","unstructured":"Figueroa AA, Polley JW, Friede H, et al. Long-term skeletal stability after maxillary advance-ment with distraction osteogenesis using a rigid external distraction device in cleft maxillary deformities. Plast Reconst Surg. 2004;114:1382\u20131392; discussion 93\u201394. https:\/\/doi.org\/10.1097\/01.PRS.0000138593.89303.1B","DOI":"10.1097\/01.PRS.0000138593.89303.1B"},{"key":"39041","doi-asserted-by":"crossref","unstructured":"Phillips JH, Nish I, Daskalogiannakis J. Orthognathic surgery in cleft patients. Plast Reconstruc-tive Surg. 2012;129:535e\u2013548e. https:\/\/doi.org\/10.1097\/PRS.0b013e31824128e6","DOI":"10.1097\/PRS.0b013e31824128e6"},{"key":"39042","doi-asserted-by":"crossref","unstructured":"Kloukos D, Fudalej P, Sequeira-Byron P, et al. Maxillary distraction osteogenesis versus orthog-nathic surgery for cleft lip and palate patients. Cochrane Database Syst Rev. 2018;8:CD010403. https:\/\/doi.org\/10.1002\/14651858.CD010403.pub3","DOI":"10.1002\/14651858.CD010403.pub3"},{"key":"39043","doi-asserted-by":"crossref","unstructured":"Cohen SR, Rutrick RE, Burstein FD. Distraction osteogenesis of the human craniofacial skele-ton: initial experience with new distraction system. J Craniofac Surg. 1995;6:368\u2013374. https:\/\/doi.org\/10.1097\/00001665-199509000-00007","DOI":"10.1097\/00001665-199509000-00007"},{"key":"39044","doi-asserted-by":"crossref","unstructured":"Cohen SR, Burstein FD, Stewart MB, et al. Maxillary-midface distraction in children with cleft lip and palate: a preliminary report. Plast Reconst Surg. 1997;99:1421\u20131428. https:\/\/doi.org\/10.1097\/00006534-199705000-00036","DOI":"10.1097\/00006534-199704001-00036"},{"key":"39045","doi-asserted-by":"crossref","unstructured":"Shaw WC, Mandall NA, Mattick CR. Ethical and scientific decision making in distraction osteo-genesis. Cleft Palate Craniofac J. 2002;39:641\u2013645. https:\/\/doi.org\/10.1597\/1545-1569_2002_039_0641_easdmi_2.0.co_2","DOI":"10.1597\/1545-1569_2002_039_0641_easdmi_2.0.co_2"},{"key":"39046","doi-asserted-by":"crossref","unstructured":"Alaluusua S, Turunen L, Saarikko A, et al. The effects of Le Fort I osteotomy on velopharyngeal function in cleft patients. J Craniomaxillofac Surg. 2019;47:239\u2013244. https:\/\/doi.org\/10.1016\/j.jcms.2018.11.016","DOI":"10.1016\/j.jcms.2018.11.016"},{"key":"39047","doi-asserted-by":"crossref","unstructured":"Chua HD, Whitehill TL, Samman N, et al. Maxillary distraction versus orthognathic surgery in cleft lip and palate patients: effects on speech and velopharyngeal function. Int J Oral Maxillo-fac Surg. 2010;39:633\u2013640. https:\/\/doi.org\/10.1016\/j.ijom.2010.03.011","DOI":"10.1016\/j.ijom.2010.03.011"},{"key":"39048","doi-asserted-by":"crossref","unstructured":"Chanchareonsook N, Whitehill TL, Samman N. Speech outcome and velopharyngeal function in cleft palate: comparison of Le Fort I maxillary osteotomy and distraction osteogenesis \u2013 early results. Cleft Palate Craniofac J. 2007;44:23\u201332. https:\/\/doi.org\/10.1597\/05-003","DOI":"10.1597\/05-003"},{"key":"39049","doi-asserted-by":"crossref","unstructured":"Harjunpaa R, Alaluusua S, Leikola J, et al. Le Fort I osteotomy in cleft patients: maxillary ad-vancement and velopharyngeal function. J Craniomaxillofac Surg. 2019;47:1868\u20131874. https:\/\/doi.org\/10.1016\/j.jcms.2019.11.017","DOI":"10.1016\/j.jcms.2019.11.017"},{"key":"39050","doi-asserted-by":"crossref","unstructured":"Smedberg E, Neovius E, Lohmander A. Impact of maxillary advancement on speech and velopharyngeal function in patients with cleft lip and palate. Cleft Palate Craniofac J. 2014;51:334\u2013343. https:\/\/doi.org\/10.1597\/12-304","DOI":"10.1597\/12-304"},{"key":"39051","doi-asserted-by":"crossref","unstructured":"Alaluusua S, Harjunpaa R, Turunen L, et al. The effect of maxillary advancement on articula-tion of alveolar consonants in cleft patients. J Craniomaxillofac Surg. 2020;48:472\u2013476. https:\/\/doi.org\/10.1016\/j.jcms.2020.02.002","DOI":"10.1016\/j.jcms.2020.02.002"},{"key":"39052","doi-asserted-by":"crossref","unstructured":"Tsang JMK, Yu WS, Tuomainen J, Sell D, et al. The impact of maxillary osteotomy on fricatives in cleft lip and palate: a perceptual speech and acoustic study. Folia Phoniatr Logop. 2022;74:271\u2013283. https:\/\/doi.org\/10.1159\/000520080","DOI":"10.1159\/000520080"},{"key":"39053","doi-asserted-by":"crossref","unstructured":"Hagberg E, Flodin S, Granqvist S, et al. The impact of maxillary advancement on consonant proficiency in patients with cleft lip and palate, lay listeners\u2019 opinion, and patients\u2019 satisfac-tion with speech. Cleft Palate Craniofac J. 2019;56:454\u2013461. https:\/\/doi.org\/10.1177\/1055665618784804","DOI":"10.1177\/1055665618784804"},{"key":"39054","doi-asserted-by":"crossref","unstructured":"asin L, Becker M, Svensson H, Wiedel AP. Long-term patient-reported outcomes after anterior distraction osteogenesis of the maxilla in patinets with cleft. J Plast Surg Hand Surg. 2023;57:488\u2013493. https:\/\/doi.org\/10.1080\/2000656X.2022.2164294","DOI":"10.1080\/2000656X.2022.2164294"},{"key":"39055","unstructured":"Lohmander A, Borell E, Henningsson G, et al. SVANTE Svenskt artikulations- och nasalitets-test. Manual [in Swedish]. 2nd ed. Lund: Studentlitteartur; 2015."},{"key":"39056","doi-asserted-by":"crossref","unstructured":"Lohmander A, Lundeborg I, Persson C. SVANTE \u2013 The Swedish Articulation and Nasality Test \u2013 normative data and a minimum standard set for cross-linguistic comparison. Clin Linguist Phon. 2017;31:137\u2013154. https:\/\/doi.org\/10.1080\/02699206.2016.1205666","DOI":"10.1080\/02699206.2016.1205666"},{"key":"39057","unstructured":"The International Phonetic Association. The International Phonetic Alphabet (Revised to 2015). extIPA Symbols for Disordered Speech (Revised to 2008). International Phonetic Associ-ation; 2008; 2015 [Retrieved March 2 2023]. Availa-ble from:https:\/\/www.internationalphoneticassociation.org\/content\/ipa-chart"},{"key":"39058","doi-asserted-by":"crossref","unstructured":"Shriberg LD, Kwiatkowski J. Phonological disorders III: a procedure for assessing severity of involvement. J Speech Hear Disord. 1982;47:256\u2013270. https:\/\/doi.org\/10.1044\/jshd.4703.256","DOI":"10.1044\/jshd.4703.256"},{"key":"39059","doi-asserted-by":"crossref","unstructured":"Cicchetti DV. The precision of reliability and validity estimates re-visited: distinguishing be-tween clinical and statistical significance of sample size requirements. J Clin Exp Neuropsy-chol. 2001;23:695\u2013700. https:\/\/doi.org\/10.1076\/jcen.23.5.695.1249","DOI":"10.1076\/jcen.23.5.695.1249"},{"key":"39060","doi-asserted-by":"crossref","unstructured":"Klint\u00f6 K, Lohmander A. Does the recording medium influence phonetic transcription of cleft palate speech? Int J Lang Commun Disord. 2017;52:440\u2013449. https:\/\/doi.org\/10.1111\/1460-6984.12282","DOI":"10.1111\/1460-6984.12282"},{"key":"39061","doi-asserted-by":"crossref","unstructured":"Havstam C, Lohmander A, Dahlgren Sandberg A, et al. Speech and satisfaction with outcome of treatment in young adults with unilateral or bilateral complete clefts. Scand J Plast Reconst Surg Hand Surg. 2008;42:182\u2013189. https:\/\/doi.org\/10.1080\/02844310802055102","DOI":"10.1080\/02844310802055102"},{"key":"39062","doi-asserted-by":"crossref","unstructured":"Brunneg\u00e5rd 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;44:33\u201344. https:\/\/doi.org\/10.1597\/05-164","DOI":"10.1597\/05-164"},{"key":"39063","doi-asserted-by":"crossref","unstructured":"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;49:657\u2013671. https:\/\/doi.org\/10.1597\/11-085","DOI":"10.1597\/11-085"},{"key":"39064","doi-asserted-by":"crossref","unstructured":"Brunneg\u00e5rd K, Hagberg E, Havstam C, et al. Reliability of speech variables and speech-related quality indicators in the swedish cleft lip and palate registry. Cleft Palate Craniofac J. 2020;57:715\u2013722. https:\/\/doi.org\/10.1177\/1055665619894497","DOI":"10.1177\/1055665619894497"}],"container-title":["Journal of Plastic Surgery and Hand Surgery"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/12308\/23500","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/12308\/23500","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T08:10:18Z","timestamp":1695888618000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/view\/12308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,28]]},"references-count":26,"URL":"https:\/\/doi.org\/10.2340\/jphs.v58.12308","relation":{},"ISSN":["2000-6764"],"issn-type":[{"value":"2000-6764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,28]]}}}