New thesis on long-term evaluation of patients born with total unilateral cleft lip and palate

Petra Peterson at the Reconstructive Plastic Surgery research group, Department of Molecular Medicine and Surgery, will defend her thesis "A multidisciplinary long-term evaluation of patients born with unilateral cleft lip and palate treated with different surgical protocols" on December 2, 2022.

What's the main focus of your thesis?

My thesis is about multidisciplinary long-term follow-up and evaluation of the outcome after different surgical protocols used for treating patients born with unilateral cleft lip and palate (UCLP).

Which are the most important results?

The most important results are the conclusions that to be able to detect differences between surgical protocols concerning craniofacial growth and dental arch relationships it is necessary to conduct follow-up until young adulthood. Also, even though the results after bonegrafting of the alveolus cleft are good there is a vulnerability in the periodontal status ten years after surgery which has to be treated prophylactically.

In addition, speech outcome was similar after different techniques of palatal repair in patients born with UCLP but the burden of care to reach those results was different between the study groups. However, individuals born with UCLP were more satisfied with their speech and communicative ability at 19 years of age compared to peers born without a cleft.

How can this new knowledge contribute to the improvement of people's health?

This new knowledge pinpoints the importance of conducting long-term follow-up after treatment for UCLP to certify that the surgical techniques used produces the best possible outcome, in all aspects, with the least burden of care. We have also shown that there seems to be a continuous need for prophylaxis and rigorous oral hygiene in these individuals to avoid negative effects on their general health as adults.

What are your future ambitions?

Personally, I would like to continue to study the patient group in this thesis project with a particular focus on the individuals who were operated with a so-called pharyngeal flap for improving of their hypernasal speech. They have an increased risk of developing obstructive sleep apnea syndrome (OSAS) after the operation and it is important to know if this risk still exists in adulthood.

Furthermore, it would be very interesting to try out the AI technology in predicting outcome at 19 years with data on speech, craniofacial growth and psychosocial well-being collected at 5 years of age. The future goal is to not have to wait so many years before one can conclude if a treatment strategy is efficient in all aspects of care long-term.

I would also like to continue the work I have done with the national quality registry for patients born with cleft lip ad palate and to incorporate a patient reported outcome measure (PROM)-instrument in the registry. We must analyze the PROM we use in our team today and evaluate how it can guide us in the patientcare. Specifically, I would like to use it as a continuation of my thesis project to ask young adult patients born with UCLP also what they think about their teeth and facial appearance.

However, I think the most important future ambition is to show the strength of reporting our research on individuals born with clefts jointly, where every specialist presents the outcome on the same group of patients together with the others, since this is how we work-as a team around and with the patient.