Should left- and right-sided unilateral cleft lip and palate patients be grouped together when reporting the outcomes?

Manar Al-Hassani*, Peter V Fowler, Yvonne E Wren, Sam D Leary, Amy J V Davies

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Objectives
Investigate associations between cleft laterality in patients with non-syndromic unilateral cleft lip and palate (UCLP) and oral-health, dental-arch, speech, audiological, psychological and nasolabial-aesthetic outcomes.

Methods
Secondary data analysis of the outcomes of 5-year-old children with non-syndromic complete UCLP identified from three studies: Cleft Collective (n = 155), Cleft Care UK (CCUK) (n = 266) and Clinical Standards Advisory Group (CSAG) study (n = 238). Outcome measures included occlusal assessment using the 5-year-old's index score, speech intelligibility rating using the CAPS-A Audit tool, audiological assessment using pure tone audiometry, nasolabial aesthetic assessment using the Asher-McDade tool, oral-health assessment using decayed, missing, filled teeth scores and parent-reported outcomes. Logistic regression with adjustment for age, sex and index-of-multiple-deprivation scores were performed.

Results
No differences were found in patient-reported outcomes between the left and right clefts in the Cleft Collective study. From the CCUK study, right clefts had poorer speech (n = 236; 95% CI 1.09, 3.42; and P = .03) and hearing outcomes (n = 211; 95% CI 1.03, 3.43; P = .04). In the CSAG study, patients with left clefts were more likely to be teased (n = 213; 95% CI 0.26, 0.85; and P = .01).

Conclusion
Weak associations between cleft laterality, speech, hearing and psychological outcomes were found, however the findings were inconsistent across the studies. This study contributes to evidence of associations between laterality and outcomes in children born with UCLP.
Original languageEnglish
Pages (from-to)49-61
Number of pages13
JournalOrthodontics and Craniofacial Research
Volume27
Issue numberS1
Early online date9 Jan 2024
DOIs
Publication statusE-pub ahead of print - 9 Jan 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors. Orthodontics & Craniofacial Research published by John Wiley & Sons Ltd.

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