Voice Quality in Adults Treated for Unilateral Cleft Lip and Palate

Abstract

Objectives: The aim of the current study was to assess voice quality among adults treated for unilateral cleft lip and palate (UCLP), after one- or two-stage palate closure, and compare it to a noncleft control group. Study Design: Cross-sectional study of patients with UCLP with long-term follow-up and noncleft controls. Participants: Patients with UCLP born between 1960 and 1987, treated at Uppsala University Hospital, Sweden, were examined (n = 73) at a mean of 35 years after primary surgery. Forty-seven (64%) patients had been treated with 1-stage palate closure and 26 with 2-stage closure (36%). The noncleft control group consisted of 63 age-matched volunteers. Main Outcome Measures: Ratings of perceptual voice characteristics from blinded voice recordings with Swedish Voice Evaluation Approach method. Acoustic voice analysis including pitch and spectral measures. Results: Among the patients, the mean values for the 12 evaluated variables on a visual analog scale (0 = no abnormality, 100 = maximal abnormality) ranged between 0.1 and 17, and the mean for all was 6 mm. Voice variables were similar between patients and controls, except the total mean of all the perceptual voice variables, as well as “vocal fry”; both slightly lower among patients ( P = .018 and P = .009). There was no difference in any variable between patients treated with 1-stage and 2-stage palate closure. No clear relationship was found between velopharyngeal insufficiency and dysphonia. Conclusions: The voice characteristics among adults treated for UCLP in childhood are not different from those of individuals without cleft.