What is your thesis about?
My thesis is about multidisciplinary long-term follow-up of people born with cleft lip, jaw and palate (LCG) who were operated on with different surgical techniques.
What are the main results?
The most important results are that you can see the importance of following up the operated patients until adulthood to assess differences regarding facial growth between different surgical techniques and that the outcome after bone grafting to the cleft jaw is good even ten years after surgery but that there is a higher risk for inflammation of the gums in the area that needs to be prevented.
The speech is relatively normal at the age of 19 after two different types of surgical protocols, but the patients have had to various extents to undergo secondary operations to achieve that result. Finally, the patients are more satisfied with their own speech and their communicative ability compared to peers born without a LKG cleft.
How can that knowledge benefit people/contribute to improving people’s health?
Our results can help to clarify the need for multidisciplinary long-term follow-up of individuals born with a cleft to be able to ensure that the surgical techniques and interventions used provide the best outcome in the long term, with the least number of surgical interventions and treatments for the patients.
It is also important to spread the knowledge that these people need continued preventive oral hygiene so that negative effects on general health can be avoided in adulthood. That young adults born with a LKG cleft are largely satisfied with their ability to speak and communicate with others is the most important knowledge, but we must continue to evaluate larger groups of patients to understand how we can help those who are less satisfied on a early phase.
What goals do you have for the future?
Personally, I would like to continue to evaluate the patient group that I have now studied, among other things, regarding how the patients who needed secondary, speech-improving surgery with so-called pharyngeal sphincter are doing today. Above all, I would like to offer screening for obstructive sleep apnea syndrome (OSAS) because there is an increased risk of OSAS if you have had surgery for pharyngeal sphincter. It is unclear how big the risk is in adults who had a pharyngeal hernia as a child.
Then it would be very interesting to see how AI technology can be used to predict outcomes in young adults based on the results regarding speech, facial growth and psychosocial health that are already measured at the age of 5. The best thing would be if you didn’t have to wait 19 years to get information about whether a treatment regimen is effective in all areas or not.
I would also like to continue working with the national quality registry that can help us evaluate larger groups of patients operated on according to different surgical protocols. We also need to evaluate the patient-reported measures (PROM) we use today in the management of care and use them to measure what young adults born with LKG cleft think about their bite and face.
The most important of my goals, however, is that we must demonstrate the strength of presenting research on people born with a cleft together, where all specialists report results on the same group of patients, together, because we work in a team around and with the patient.