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Surgical, speech, and hearing outcomes at five years of age in internationally adopted children and Swedish-born children with cleft lip and/or palate
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. Institute of Neuroscience and Physiology, Speech Language Pathology Unit, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.ORCID iD: 0000-0002-8656-8064
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2020 (English)In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 54, no 1, p. 6-13Article in journal (Refereed) Published
Abstract [en]

Internationally adopted children (IAC) with a cleft lip and/or palate (CL/P) tend to arrive with un-operated palates at an age at which their Swedish-born peers have completed their primary palate surgery. Our aim of the present study was to analyze surgical, speech and hearing outcomes of IAC at age 5 and compare with those of a matched group of Swedish-born children. Fifty children with CL/P born in 1994-2005 participated in the study. Twenty-five IAC were matched according to age, sex and cleft type with 25 Swedish-born children. Audio recordings were perceptually analyzed by two experienced, blinded speech-language pathologists. Hearing and speech statuses were evaluated on the same day for all children. Surgical timing and complications as in fistulas and requirement for secondary velopharyngeal (VP) surgery, speech evaluation results, and present hearing status were analyzed for all children of age 5 years. Results showed that primary palatal surgery was delayed by a mean of 21 months in IAC. IAC had a higher prevalence of velopharyngeal impairment that was statistically significant, a higher fistula rate, and experienced more secondary surgery than Swedish-born peers. Hearing loss due to middle ear disease was slightly more common among IAC, whereas the rate of treatment with tympanostomy tubes was similar between the two groups. In conclusion, IAC with CL/P represent a challenge for CL/P teams because of the heterogeneous nature of the patient group and difficulties associated with delayed treatment, and the results show the importance of close follow-up over time.

Place, publisher, year, edition, pages
Informa UK Limited , 2020. Vol. 54, no 1, p. 6-13
Keywords [en]
Cleft palate, cleft palate surgery, hearing, internationally adopted, palatal fistulas, speech, velopharyngeal function
National Category
Surgery
Identifiers
URN: urn:nbn:se:uu:diva-459539DOI: 10.1080/2000656X.2019.1650056ISI: 000481063000001PubMedID: 31393744OAI: oai:DiVA.org:uu-459539DiVA, id: diva2:1614361
Available from: 2021-11-25 Created: 2021-11-25 Last updated: 2023-11-27Bibliographically approved

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Jonasson, Åsa

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