{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:52:46Z","timestamp":1787032366415,"version":"build-2736575974"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"vor","delay-in-days":1815,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2017,5,22]],"date-time":"2017-05-22T00:00:00Z","timestamp":1495411200000},"content-version":"tdm","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Department of Plastic Surgery"}],"content-domain":{"domain":["www.e-aps.org"],"crossmark-restriction":true},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:p>Background  No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP).<\/jats:p>\n                  <jats:p>Methods  This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients \u226517 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation.<\/jats:p>\n                  <jats:p>Results  Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P&lt;0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%\u201317% of the patients exhibited increased nasalance scores, assessed through nasometry.<\/jats:p>\n                  <jats:p>Conclusions  The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.<\/jats:p>","DOI":"10.5999\/aps.2017.44.3.202","type":"journal-article","created":{"date-parts":[[2017,5,26]],"date-time":"2017-05-26T06:53:41Z","timestamp":1495781621000},"page":"202-209","update-policy":"https:\/\/doi.org\/10.5999\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes"],"prefix":"10.1055","volume":"44","author":[{"given":"Isabelle Francisca Petronella Maria","family":"Kappen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Bittermann","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard Koendert Pieter","family":"Bittermann","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Boonacker","sequence":"additional","affiliation":[{"name":"Julius Centre for Health Sciences and Primary Care, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Haverkamp","sequence":"additional","affiliation":[{"name":"Speech and Language Pathology, ENT-Surgery, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hester","family":"de Wilde","sequence":"additional","affiliation":[{"name":"Speech and Language Pathology, ENT-Surgery, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marise","family":"Van Der Heul","sequence":"additional","affiliation":[{"name":"Speech and Language Pathology, ENT-Surgery, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom FJMC","family":"Specken","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Koole","sequence":"additional","affiliation":[{"name":"Speech and Language Pathology, ENT-Surgery, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moshe","family":"Kon","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corstiaan Cornelis","family":"Breugem","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University Medical Centre of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aebele Barber","family":"Mink van der Molen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,4,20]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1016\/S0140-6736(09)60695-4","article-title":"Cleft lip and palate","volume":"374","author":"PA Mossey","year":"2009","journal-title":"Lancet"},{"key":"ref2","first-page":"51","article-title":"The problem of early and late surgery in congenital fissure of the of the lips and palate","volume":"30","author":"H Schweckendiek","year":"1951","journal-title":"Z Laryngol Rhinol Otol"},{"key":"ref3","first-page":"268","article-title":"Primary veloplasty: long-term results without maxillary deformity. a twenty-five year report","volume":"15","author":"W Schweckendiek","year":"1978","journal-title":"Cleft Palate J"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/00006534-198402000-00007","article-title":"Late results of primary veloplasty: the Marburg 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Part 5: timing of palate repair","volume":"24","author":"RB Ross","year":"1987","journal-title":"Cleft Palate J"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1097\/01.prs.0000258518.81309.70","article-title":"Delayed closure of the hard palate leads to speech problems and deleterious maxillary growth","volume":"119","author":"S Holland","year":"2007","journal-title":"Plast Reconstr Surg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/13682820400016522","article-title":"Issues in perceptual speech analysis in cleft palate and related disorders: a review","volume":"40","author":"D Sell","year":"2005","journal-title":"Int J Lang Commun Disord"},{"key":"ref16","first-page":"354","article-title":"Evaluation of unilateral cleft lip and palate treatment: long term results","volume":"27","author":"H Enemark","year":"1990","journal-title":"Cleft Palate J"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1097\/01.PRS.0000105332.57124.89","article-title":"From birth to maturity: a group of patients who have completed their protocol management. 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