Breakey, William

Butterworth, Sophie

de Blacam, Catherine

Fell, Matthew

Hodgkinson, Peter

Mullen, Joanne

Murphy, Colm

Sainsbury, David C G

Williams, Caroline C

Wren, Yvonne E

English

ObjectiveIdentification of patient factors influencing velopharyngeal function for speech following initial cleft palate repair.DesignA literature search of relevant databases from inception until 2018 was performed using medical subject headings and keywords related to cleft palate, palatoplasty and speech assessment. Following three stage screening data extraction was performed.SettingSystematic review and meta-analysis of relevant literature.Patients/ParticipantsThree hundred and eighty-three studies met the inclusion criteria, comprising data on 47 658 participants.InterventionsIndividuals undergoing initial palatoplasty.Main Outcome MeasuresStudies including participants undergoing initial cleft palate repair where the frequency of secondary speech surgery and/or velopharyngeal function for speech was recorded.ResultsPatient factors reported included cleft phenotype (95% studies), biological sex (64%), syndrome diagnosis (44%), hearing loss (28%), developmental delay (16%), Robin Sequence (16%) and 22q11.2 microdeletion syndrome (11%). Meta-analysis provided strong evidence that rates of secondary surgery and velopharyngeal dysfunction varied according to cleft phenotype (Veau I best outcomes, Veau IV worst outcomes), Robin Sequence and syndrome diagnosis. There was no evidence that biological sex was associated with worse outcomes. Many studies were poor quality with minimal follow-up.ConclusionsMeta-analysis demonstrated the association of certain patient factors with speech outcome, however the quality of the evidence was low. Uniform, prospective, multi-centre documentation of preoperative characteristics and speech outcomes is required to characterise risk factors for post-palatoplasty velopharyngeal insufficiency for speech.Systematic Review RegistrationRegistered with PROSPERO CRD42017051624

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Patient Factors Influencing Speech Outcomes in Velopharyngeal Function Following Initial Cleft Palate Repair: A Systematic Review and Meta-Analysis

https://research-information.bris.ac.uk/files/379223826/Final_SR_Manuscript_9_July_2023.pdf

Patient Factors Influencing Speech Outcomes in Velopharyngeal Function Following Initial Cleft Palate Repair: A Systematic Review and Meta-Analysis

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