Male-to-female transsexual individuals frequently experience difficulties in increasing the fundamental frequency so that they can pass as members of the preferred gender. Female-to-male individuals may also meet with vocal problems although hormone treatment lowers fundamental frequency. The purpose of this study was to explore the transsexual individuals who, as part of their reassignment process, were referred to the voice clinic at the Sahlgrenska University Hospital in Göteborg, Sweden, between 1991 and 2002. The group comprised 22 male-to-female and 3 female-to-male transsexuals. Video recorded laryngeal examinations revealed basically normal conditions. More than half the patients showed supraglottal constriction on phonating at both habitual and preferred levels. A comparison between acoustic analyses before therapy and at follow-up visits showed increased fundamental frequencies for male-to-female individuals (p = < 0.01). Vocal fatigue was reduced. Degree of satisfaction with the post-therapy voice was not related to number of therapy sessions.
Children with a cleft in the soft palate only, with no additional malformations, had satisfactory speech, while children with a cleft palate accompanied by additional malformations or as a part of a syndrome should be considered to be at risk for speech problems.
Language difficulties in all investigated areas of language were found. It is suggested that speech-language impairment is a common feature of 22q11 deletion syndrome. An implication of these results is that follow-ups of language skills are important not only for pre-school children, but also for school age children and adolescents with 22q11 deletion syndrome.
Objective The purpose of the study was to study the speech outcome in a series of 5-year-old children born with an isolated cleft palate and compare the speech with that of noncleft children and to study the impact of cleft extent and additional malformation on the speech outcome. Design A cross-sectional retrospective study. Setting A university hospital serving a population of 1.5 million inhabitants. Subjects Fifty-one patients with an isolated cleft palate; 22 of these had additional malformations. Thirteen noncleft children served as a reference group. Interventions A primary soft palate repair at a mean of 8 months of age and a hard palate closure at a mean age of 4 years and 2 months if the cleft extended into the hard palate. Main outcome Measures Perceptual judgment of seven speech variables assessed on a five-point scale by three experienced speech pathologists. Results The cleft palate group had significantly higher frequency of speech symptoms related to velopharyngeal function than the reference group. There were, however, no significant differences in speech outcome between the subgroup with a nonsyndromic cleft and the reference group. Cleft extent had a significant impact on the variable retracted oral articulation while the presence of additional malformations had a significant impact on several variables related to velopharyngeal function and articulation errors. Conclusion Children with a cleft in the soft palate only, with no additional malformations, had satisfactory speech, while children with a cleft palate accompanied by additional malformations or as a part of a syndrome should be considered to be at risk for speech problems.
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