The Perspectives of Children and Young People Living with Cleft Lip and Palate: A Review of Qualitative Literature

Objective: To explore the nature of psychosocial adjustment in young people with a cleft as well as in their parents, within the framework of Lazarus and Folkman's (1984) transactional model of stress and coping. Design, Participants, Setting: A cross-sectional postal questionnaire design study was used, involving young people aged between 11 and 16 years and their parents. There were 145 families from two cleft services participating in the study. Outcome Measures: Participants completed measures of psychological adjustment, coping, social experiences, satisfaction with appearance, cleft-related factors, and demographic information. Results: Young people with a cleft and their mothers did not report psychosocial adjustment difficulties above that of the normal population. An insufficient number of fathers were recruited for substantive analysis to be conducted using their data. Conclusions: The findings show little evidence of significant psychosocial adjustment difficulties for adolescents with a cleft or for their mothers. The concepts of adjustment, coping, satisfaction with appearance, and maternal mental health in this population are discussed. The results highlight the importance of timely interventions and seeking multiple perspectives in clinical management of a cleft. Questions are raised about the completion of self-report measures for future research in this population.

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Scores of the Cleft Hearing, Appearance and Speech Questionnaire (CHASQ) in Swedish Participants With Cleft lip and/or Cleft Palate and a Control Population

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620952296 ◽

2020 ◽

pp. 105566562095229

Author(s):

Mia Stiernman ◽

Kristina Klintö ◽

Martin Persson ◽

Magnus Becker

Keyword(s):

Young People ◽

Cleft Palate ◽

Cleft Lip ◽

Cross Sectional Study ◽

Control Population ◽

Cross Sectional ◽

Children And Young People ◽

Sports Club ◽

Significant Difference ◽

And Control

Objective: The primary aim of this study was to investigate whether there was any difference in scores of the Cleft Hearing, Appearance and Speech Questionnaire (CHASQ) between patients with cleft lip and/or cleft palate (CL/P) and a control population. The second aim was to compare CL/P and control population scores in this study with a British norm CL/P population. Design: Single-site, cross-sectional study with an age-matched control population. Setting: Participants were recruited from a hospital, a school, and a sports club. They answered the CHASQ in the hospital or at home. Participants: Sixty-four participants with CL/P (7-19 years of age) and a control population of 56 participants without CL/P (9-20 years of age). Main Outcome Measure: CHASQ. Results: There was no statistically significant difference in satisfaction with cleft-related features between the CL/P and the control population. Participants with CL/P were significantly more satisfied with non-cleft-related features than the control population. Cleft Hearing, Appearance and Speech Questionnaire scores were also similar to earlier established British normative data of a CL/P population. Conclusion: The results indicated that children and young people with CL/P were as satisfied with their appearance, hearing, and speech as children and young people without CL/P. Swedish CHASQ scores were also similar to British scores.

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Treating Velopharyngeal Inadequacy Using Bilateral Buccal Flap Revision Palatoplasty

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig5-2019-0005 ◽

2019 ◽

Vol 4 (5) ◽

pp. 878-892

Author(s):

Joseph A. Napoli ◽

Linda D. Vallino

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

A Priori ◽

Sufficient Evidence ◽

Obstructive Sleep ◽

Before And After ◽

Buccal Flap

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

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