{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:39:59Z","timestamp":1778823599510,"version":"3.51.4"},"reference-count":34,"publisher":"Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T00:00:00Z","timestamp":1686700800000},"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>Background: Delayed hard palate closure in unilateral cleft lip and palate (UCLP) patients show on a safe surgical method and good speech outcome, however, occurrence of orally retracted articulation before hard palate closure at 8 years. The aim of this study was to describe surgical and speech outcome in UCLP patients closing the hard palate at 3 years.Methods: A consecutive of 28 participants were operated with Gothenburg two-stage method including soft palate closure at 6 months and hard palate at 3 years. Surgical and speech outcome were evaluated. Recordings of sentences and spontaneous speech at 5, 10, 16, and 19 years were analyzed blindly and independently by three speech-language pathologists. Compensatory articulation, hypernasality, hyponasality, weak pressure consonants, and nasal air leakage were evaluated on ordinal four-point and intelligibility and perceived velopharyngeal function on three-point scales. Results: Long-term follow-up revealed a safe surgical method. Articulation disorders were present in 25\u201330% at 5-year but largely not later. About 20% had incompetent velopharyngeal function at 5 years but none at 19 years. Most participants were well intelligible after 5 years. Hard palate closure at 3 years indicated less occurrence of orally retracted articulation compared with a cohort who had hard palate closure at 8.2 years.Conclusions: Long-term, follow-up of individuals with UCLP after Gothenburg two-stage palate closure including closure of the soft palate closure at 6 months and hard palate at 3 years of age shows a safe surgical method and indicates less retracted oral articulation compared with hard palate closure at 8 years.<\/jats:p>","DOI":"10.2340\/jphs.v58.7317","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T08:57:59Z","timestamp":1686733079000},"page":"19-25","source":"Crossref","is-referenced-by-count":7,"title":["Long-term longitudinal follow-up of individuals with UCLP after Gothenburg twostage palate closure: surgical and speech outcomes"],"prefix":"10.2340","volume":"58","author":[{"given":"Hans","family":"Mark","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Lilja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Havstam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"key":"34145","doi-asserted-by":"crossref","unstructured":"Shi B, Losee JE. The impact of cleft lip and palate repair on maxillofacial growth. Int J Oral Sci. 2015;7(1):14\u201317. https:\/\/doi.org\/10.1038\/ijos.2014.59","DOI":"10.1038\/ijos.2014.59"},{"key":"34146","doi-asserted-by":"crossref","unstructured":"Crowley JS, Friesen TL, Gabriel RA, et al. Speech and audiology outcomes after single-stage versus early 2-stage cleft palate repair. Ann Plast Surg. 2021;86(5 Suppl 3):S360\u2013S366. https:\/\/doi.org\/10.1097\/SAP.0000000000002747","DOI":"10.1097\/SAP.0000000000002747"},{"key":"34147","doi-asserted-by":"crossref","unstructured":"Friede H, Lilja J, Lohmander A. Cleft palate craniofac J. long-term, longitudinal follow-up of individuals with UCLP after the Gothenburg primary early veloplasty and delayed hard palate closure protocol: maxillofacial growth outcome. Cleft Palate Craniofac J. 2012;49(6):649\u2013656. https:\/\/doi.org\/10.1597\/10-252","DOI":"10.1597\/10-252"},{"key":"34148","unstructured":"Johanson B, Lilja J, Friede H. The evolution of the therapeutic approach to cleft lip and palate in Gothenburg. In: Hotz M, Gnoinski W, Perko M, Nussbaumer H, Hof E, Haubensak R, eds. Early Treatment of Cleft Lip and Palate. Toronto: Hans Huber; 1986, pp. 85\u201389."},{"key":"34149","doi-asserted-by":"crossref","unstructured":"Friede H, Lilja J. Dentofacial morphology in adolescent or early adult patient with cleft lip and palate after a treatment regimen that included vomer flap surgery and pushback palatal repair. Scand J Plast Reconstr Hand Surg. 1994;28(2):113\u2013121. https:\/\/doi.org\/10.3109\/02844319409071188","DOI":"10.3109\/02844319409071188"},{"key":"34150","doi-asserted-by":"crossref","unstructured":"Friede H, Lilja J, Lohmander A, et al. Maxillary dental arch and occlusion in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair. 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