Speech Outcomes in Isolated Cleft Palate: Impact of Cleft Extent and Additional Malformations

Abstract

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.

Speech in 10-Year-Olds Born with Cleft Lip and Palate: What Do Peers Say?

“…A comparable high occurrence of hypernasality was also found in the CPS group (20%). The result in the CPH group was similar to what was found by Persson et al (2002), who evaluated speech after a two-stage protocol. However, 6% in the CPS group were rated as having moderate hypernasality.…”

“…The corresponding figure at around 10 years of age was around 80% (Lohmander, 2011). In a national prospective study in the United Kingdom, Sell et al (2001) It has been suggested that the cleft extent has an impact on speech outcome in children born with CPO -that is, the larger the extent of the cleft, the higher the impact on both velopharyngeal function (Brunnegård & Lohmander, 2007;Nyberg et al, 2010;Bicknell et al, 2002) and articulation (Persson et al, 2002). The influence of the cleft extent on articulation reported in earlier studies (Jakobsson et al, 1990;Lohmander-Agerskov et al, 1993), was confirmed in the study by Persson et al (2006), who showed a higher prevalence of retracted oral articulation in children with CPH than in children with CPS.…”

Strategies to Improve Regeneration of the Soft Palate Muscles After Cleft Palate Repair

“…Diverse factors are attributed to suboptimal repair such as age at the time of the surgery, skills and experience of the surgeon, type and extension of the cleft, fibrosis, damage of the motor and proprioceptive innervation, and abnormal fiber type distribution. 7,[9][10][11][12] This review will highlight the myogenesis and characteristics of the soft palate muscles in the noncleft and cleft palate, and the process of muscle regeneration. We postulate that muscle healing and function after soft palate repair can be improved by adjuvant strategies from the field of regenerative medicine.…”

Concordância entre testes perceptivo-auditivos e nasofaringoscopia no diagnóstico da disfunção velofaríngea

“…LEE, 2003;HENNINGSSON et al, 2008). Já a emissão de ar nasal é definida como um escape de ar (audível ou não) através da válvula velofaríngea (JOHNS;ROHRICH;AWADA, 2003;BRIGGS;LEE, 2003;TRINDADE et al, 2005;HENNINGSSON et al, 2008;KUMMER, 2008 -CARDAMONE, 1989;SEAGLE et al, 2002;CABLE et al, 2004;MALICK;CANADY, 2007;KUMMER, 2008;TUNA et al, 2010;NABI et al, 2011;KUMMER et al, 2012;SAMAN;TATUM III, 2012 DOTEVAL et al, 2002;PERSSON et al, 2002;SELL et al, 2002;SOMMERLAD et al, 2002;VAN LIERDE et al, 2002;BRIGGS;LEE, 2003;MEHENDALE et al, 2004;VAN LIERDE et al, 2004;LIEDMAN-BOSHKO et al, 2005;PAAL et al, 2005;TRINDADE et al, 2005;JOHN et al, 2006;PERSSON;LOHMANDER;ELANDER, 2006;BRUNNEGARD;LOHMANDER, 2007;HOLLAND et al, 2007;VAN LIERDE et al, 2007;HENNINGSSON et al, 2008;KHO...…”

“…Whitehill et al, (2002) sugerem que a nasalidade é uma sensação perceptiva protética e que, portanto, não poderiam ser classificadas por meio de escalas de intervalos iguais, uma vez que este tipo de escala demanda dos ouvintes partilhar as sensações em categorias discretas. Entretanto, este tipo de escala é muito comum nos estudos que investigam fala e ressonância (DALSTON et al, 1991;HARDIN et al, 1992;WATTERSON et al, 1998 , 2000;DOTEVAL et al, 2002;PERSSON et al, 2002;SELL et al, 2002;SOMMERLAD et al, 2002;VAN LIERDE et al, 2002;BRIGGS;LEE, 2003;MEHENDALE et al, 2004;VAN LIERDE et al, 2004;LIEDMAN-BOSHKO et al, 2005;PAAL et al, 2005;TRINDADE et al, 2005;JOHN et al, 2006;PERSSON;LOHMANDER;ELANDER, 2006;BRUNNEGARD;LOHMANDER, 2007;HOLLAND et al, 2007;VAN LIERDE et al, 2007;HAVSTAM et al, 2008;HENNINGSSON et al, 2008;KHOSLA;MABRY;CASTIGLIONE, 2008;LOHMANDER;PERSSON, 2008;SWEENEY;SELL, 2008;LOHMANDER et al, 2009;RULLO et al, 2009;BAYLIS;MUNSON;MOLLER, 2010;…”