Phonological Profile of Patients With Velopharyngeal Dysfunction and Palatal Anomalies

2021 ◽  
pp. 1-15
Author(s):  
Ariela Nachmani ◽  
Muhamed Masalha ◽  
Firas Kassem
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Age Groups ◽  
Phonological Process ◽  
Phonological Processes ◽  
Process Error ◽  
Submucous Cleft Palate ◽  
Different Types

Purpose This purpose of this study was to assess the frequency and types of phonological process errors in patients with velopharyngeal dysfunction (VPD) and the different types of palatal anomalies. Method A total of 808 nonsyndromic patients with VPD, who underwent follow-up at the Center for Cleft Palate and Craniofacial Anomalies, from 2000 to 2016 were included. Patients were stratified into four age groups and five subphenotypes of palatal anomalies: cleft lip and palate (CLP), cleft palate (CP), submucous cleft palate (SMCP), occult submucous cleft palate (OSMCP), and non-CP. Phonological processes were compared among groups. Results The 808 patients ranged in age from 3 to 29 years, and 439 (54.3%) were male. Overall, 262/808 patients (32.4%) had phonological process errors; 80 (59.7%) ages 3–4 years, 98 (40, 0%) ages 4.1–6 years, 48 (24.7%) 6.1–9 years, and 36 (15.3%) 9.1–29 years. Devoicing was the most prevalent phonological process error, found in 97 patients (12%), followed by cluster reduction in 82 (10.1%), fronting in 66 (8.2%), stopping in 45 (5.6%), final consonant deletion in 43 (5.3%), backing in 30 (3.7%), and syllable deletion and onset deletion in 13 (1.6%) patients. No differences were found in devoicing errors between palatal anomalies, even with increasing age. Phonological processes were found in 61/138 (44.20%) with CP, 46/118 (38.1%) with SMCP, 61/188 (32.4%) with non-CP, 70/268 (26.1%) with OSMCP, and 25/96 (26.2%) with CLP. Phonological process errors were most frequent with CP and least with OSMCP ( p = .001). Conclusions Phonological process errors in nonsyndromic VPD patients remained relatively high in all age groups up to adulthood, regardless of the type of palatal anomaly. Our findings regarding the phonological skills of patients with palatal anomalies can help clarify the etiology of speech and sound disorders in VPD patients, and contribute to general phonetic and phonological studies.

Phonological Proficiency of Two Cleft Palate Toddlers with School-Age Follow-up

1983 ◽  
Vol 48 (3) ◽  
pp. 274-285 ◽  
Author(s):  
Joan I. Lynch ◽  
Donna R. Fox ◽  
Bonnie L. Brookshire
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Sound Production ◽  
Cleft Lip And Palate ◽  
Speech Sound ◽  
Phonological Processes ◽  
Data Error ◽  
The Individual ◽  
Phonological Abilities

This study provides a comprehensive analysis of the speech-sound production of two children with repaired bilateral cleft lip and palate. Speech samples were obtained during videotaping of spontaneous interactions between the children and their parent(s) when the subjects were between 29 and 37 months of age. Re-evaluation of both language and phonological abilities was accomplished when the children were between 5 and 7 years of age. Based on phonemic transcription of these data, error matrices were prepared illustrating word-initial and word-final consonants produced. Place and manner of consonant production were analyzed and the individual phonological processes employed by each child were discussed. Results indicated individual differences between the subjects in that one subject's emerging phonological system was more characteristic of developmental delay while the other was more characteristic of structural inadequacy. These differences have implication for the management of preschool cleft palate children.

Long-Term Otologic and Audiometric Outcomes in Patients with Cleft Palate

2017 ◽  
Vol 157 (4) ◽  
pp. 676-682 ◽  
Author(s):  
Terence E. Imbery ◽  
Lindsay B. Sobin ◽  
Emily Commesso ◽  
Lindsey Koester ◽  
Sherard A. Tatum ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Medical Center ◽  
Academic Medical Center ◽  
Case Series ◽  
Closure Rate ◽  
Pressure Equalization

Objective Describe longitudinal audiometric and otologic outcomes in patients with cleft palates. Study Design Case series with chart review. Setting Single academic medical center. Methods Charts of 564 patients with a diagnosis of cleft palate (59% syndromic etiology, 41% nonsyndromic) from 1998 to 2014 were reviewed. Patients without at least 1 audiometric follow-up were excluded from analysis. Patient demographics, surgeries, audiometric tests, and otologic data were recorded for 352 patients. Results Forty-five percent had isolated cleft palates, 34% had unilateral cleft lip and palate, and 21% had bilateral cleft lip and palate. Patients were followed for a mean of 50.3 months with a mean of 3.2 separate audiograms performed. Patients received a mean of 2.93 pressure equalization tubes. Increased number of pressure equalization tubes was not associated with incidence of cholesteatoma, which was identified in only 4 patients. Nine patients underwent eventual tympanoplasty with an 89% closure rate. Analysis of mean air-bone gap by cleft type did not reveal significant differences ( P = .08), but conductive losses and abnormal tympanometry persisted into teenage years. Conclusions Patients with cleft palates have eustachian tube dysfunction, which, in our cohort, resulted in persistent conductive hearing loss, highlighting the importance of long-term follow-up. Cholesteatoma incidence was low and not associated with number of tubes, which at our institution were placed prophylactically. Tympanoplasty was successful in those with persistent perforations.

Cleft Palate Rehabilitation: Interim Strategies in Indonesia

1994 ◽  
Vol 31 (4) ◽  
pp. 316-320 ◽  
Author(s):  
Doris Schreiber Willcox
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Frequent Feeding ◽  
Speech Therapists

The following is a discussion of the formidable obstacles to cleft palate rehabilitation in Indonesia, including frequent feeding deaths, lack of timely surgery, lack of speech therapists, and lack of follow-up opportunities. It describes the work of a remarkable group of Indonesian professionals who, along with a few interested Western associates, are searching for ways to provide treatment and care for needy patients with cleft lip and palate. It details the various strategies being attempted to overcome some of these obstacles.

WITHDRAWN—Administrative Duplicate Publication: Voice Quality in Adults Treated for Unilateral Cleft Lip and Palate: Long-term Follow-up After 1- or 2-Stage Palate Repair

2018 ◽  
Vol 55 (5) ◽  
pp. 758-768 ◽  
Author(s):  
Staffan Morén ◽  
Per Åke Lindestad ◽  
Mats Holmström ◽  
Maria Mani
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Voice Quality ◽  
Two Stage ◽  
Duplicate Publication ◽  
Long Term Follow Up ◽  
Palate Repair

Morén, S., Lindestad, P. Å., Holmström, M., & Mani, M. (2018). Voice Quality in Adults Treated for Unilateral Cleft Lip and Palate: Long-term Follow-up After 1- or 2-Stage Palate Repair. The Cleft Palate-Craniofacial Journal, 55(5), 758–768. DOI: 10.1177/1055665618754946 Article withdrawn by publisher. Due to an administrative error, this article was accidentally published in Volume 55 Issue 5 as well as Volume 55 Issue 8 of publishing year 2018 with different DOIs and different page numbers. The incorrect version of the article with DOI: 10.1177/1055665618754946 has been replaced with this correction notice. The correct and citable version of the article remains: Morén, S., Lindestad, P. Å., Holmström, M., & Mani, M. (2018). Voice Quality in Adults Treated for Unilateral Cleft Lip and Palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair. The Cleft Palate-Craniofacial Journal, 55(8), 1103–1114. DOI: 10.1177/1055665618764521

Abnormal Maxillary Trapezoid Pattern in Human Fetal Cleft Lip and Palate

2008 ◽  
Vol 45 (2) ◽  
pp. 131-140 ◽  
Author(s):  
Soung Min Kim ◽  
Young Joon Lee ◽  
Sang Shin Lee ◽  
Yeon Sook Kim ◽  
Suk Keun Lee ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Nasal Septum ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Growth Patterns ◽  
Radiographic Images ◽  
Alveolar Cleft ◽  
Abnormal Growth ◽  
Bilateral Cleft Lip ◽  
Different Types

Objective: To elucidate abnormal growth patterns of human fetal maxillae with cleft lip and palate (CLP). Subject: A total of 71 fetal maxillae with CLP were obtained from aborted human fetuses. Method: Dimensions of the maxillary trapezoid (MT), formed by the maxillary primary growth centers (MxPGC), were taken from radiographic images. The CLP dimensions were compared with maxillary trapezoid dimensions of normal fetuses from a previous study (Lee et al., 1992). Main Outcome Measures: Cleft lip subjects without a cleft palate, unilateral cleft lip-alveolar cleft or cleft palate (UCL+A/UCLP), and bilateral cleft lip-alveolar cleft or cleft palate (BCL+A/BCLP) displayed abnormal MT patterns. MT abnormalities were most marked in the BCL+A/BCLP cohort. Results: The MT growth of prenatal CLP maxillae was severely arrested, resulting in abnormal MT shape on palatal radiograms. BCL+A/BCLP subjects had a more protruded nasal septum than subjects with other types of CLPs, while UCL+A/UCLP subjects showed severe deviation of the protruded nasal septum toward the noncleft side. Cleft lip-only subjects also exhibited abnormal MT growth. Conclusion: MT is primarily involved in CLPs, so that the MT shape could be utilized as a sensitive indicator for the analysis of maxillary malformation in different types of CLPs.

scholarly journals Speech resonance in orthognathic surgery in subjects with cleft lip and palate

2005 ◽  
Vol 13 (3) ◽  
pp. 232-236 ◽  
Author(s):  
Trixy Cristina Niemeyer ◽  
Adriana de Oliveira Camargo Gomes ◽  
Ana Paula Fukushiro ◽  
Katia Flores Genaro
Keyword(s):  
Confidence Interval ◽  
Cleft Palate ◽  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Perceptual Analysis ◽  
Risks And Benefits ◽  
Maxillary Advancement ◽  
The Impact

The main purpose of this study was to investigate the impact of maxillary advancement on speech resonance in subjects with cleft lip and palate. The study sample was composed of 42 subjects aged 16 to 41 years old with operated cleft palate ± lip submitted to maxillary advancement. Resonance was evaluated before and 3 to 12 months after surgery by perceptual analysis and graduated from absent to severe. It was observed that 47.5% of the subjects presented impairment of resonance after orthognathic surgery, with a confidence interval (at 95%) from 31.5% to 63.9%. These results suggest that orthognathic surgery in individuals with cleft palate may interfere in resonance, causing, or increasing the degree of hypernasality. Therefore, this highlights the importance of the orientation about the risks and benefits of maxillary advancement surgery and follow-up of these patients.

Different Cleft Conditions, Facial Appearance, and Speech: Relationship to Psychological Variables

2001 ◽  
Vol 38 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Tom Millard ◽  
Lynn C. Richman
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Hospital ◽  
Facial Appearance ◽  
Self Perception ◽  
Psychological Variables ◽  
Different Types ◽  
Depression Scales ◽  
Relationship Of

Objective The purpose of this investigation was to study the adjustment and learning characteristics of children with different types of clefts. The hypotheses were that there may be different relationships among cleft variables (speech and appearance) according to the cleft types. Design The study compared three cleft groups on behavior rating, anxiety scales, depression scales, and self-perception (analyses of variance) and examined the influence of facial and speech ratings on self-perception (multiple regression analyses). Setting All patients were treated at a university hospital cleft palate clinic. Patients Sixty-five children aged 8 years to 17 years were selected based on nonsyndromic cleft (unilateral cleft lip and palate [ULP], bilateral cleft lip and palate [BLP], and cleft palate only [CPO]) and no significant neurological condition or hearing loss. Results The findings indicated children with CPO showed greater problems with parent- and teacher-reported depression, anxiety, and learning related to speech than children with ULP or BLP. The later two groups showed fewer problems and a greater relationship of problem to facial appearance. The children with ULP self-reported lower levels of depression than the other two groups. Conclusions Children with cleft show relatively good overall adjustment, but some problems appear related to speech and facial appearance. Subgroups may need to be studied separately.

scholarly journals Study of the distribution of different types of cleft lip and palate and associated anomalies

2014 ◽  
Vol 03 (04) ◽  
pp. 203-208
Author(s):  
Alpana Barman ◽  
B C Dutta ◽  
J K Sarkar
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Type I ◽  
Type Ii ◽  
Associated Anomalies ◽  
Type Iii ◽  
Congenital Deformities ◽  
Different Types ◽  
Isolated Cleft Palate

Abstract Background : Cleft lip and palate are some of the most common congenital deformities. They frequently occur as isolated deformities, but can be associated with other medical conditions and anomalies. Aim of the study: To study the distribution of different types of cleft lip and palate and associated anomalies. Materials and methods: Forty patients of cleft lip and palate were studied. Relevant history was taken, clinical examination done and recorded with photography with consent. The cases were classified as per Nagpur Classification. Results: In our study 24 cases (60%) were cleft lip and palate (type III) and 10 cases (25%) of cleft palate alone (type II) and 6 cases (15%) of cleft lip alone (type I). Males were found to predominate in type I and III. Females predominated in type II. Among the cleft lip, left side is found to be involved in most of the cases. In our study, out of 40 cases, 8 cases (20%) had other associated anomalies. Most of these were associated with cleft lip and palate (type III) and isolated cleft palate (type II). Conclusion: The typical universal distribution of cleft types and associated anomalies tallies with our results.

Otologic Disease Following Palatoplasty In International Cleft Palate Cohort

2017 ◽  
Vol 55 (2) ◽  
pp. 162-167
Author(s):  
Jeff Markey ◽  
Rebecca Maine ◽  
Kimberly Daniels ◽  
Emily Yang Yu ◽  
George Gregory ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Country Of Origin ◽  
Multivariable Analysis ◽  
Otoacoustic Emission ◽  
Patient Characteristics ◽  
Tube Placement ◽  
Type B

Objective: Study the prevalence of otologic disease in a pediatric post-palatoplasty population with no prior ear tube placement in resource-deprived countries and assess patient characteristics associated with these abnormal results. Design: Retrospective data review. Participants: Ecuadorian and Chinese children identified during humanitarian cleft lip and palate repair trips with cleft palates undergoing palatoplasty from 2007 to 2010. Interventions: Tympanometry and otoacoustic emission (OAE) testing performed following palatoplasty. Patients’ parents administered surveys regarding perceived hearing deficits. Main Outcome Measures: Age, gender, Veau classification, follow-up time, laterality, and country of origin were evaluated for possible association with type B tympanogram, “Refer” Otoacoustic results, and presence of hearing difficulty as identified by a parent. Significant predictors were further evaluated with multivariate analysis. Results: The cohorts included 237 patients (129 Ecuadorian, 108 Chinese); mean age: 3.9 years; mean follow-up: 4.2 years. Thirty-nine percent scored type B, 38% failed OAE testing, and 8% of parents noted hearing deficits. The country of origin and a younger age were identified as predictive variables regarding type B tympanogram. Follow-up time, country of origin, and bilateral OAE “Refer” results all significantly predicted parental questionnaire results. Subsequent multivariable analysis further demonstrated effect modification between the 2 variables of age at palatoplasty and country of origin when predicting type B vs type A tympanometry. Conclusion: Without otologic intervention, cleft palate children in resource-deprived settings suffer type B tympanometry and failed OAE results with similar to increased incidences to other studied cleft palate populations with otologic interventions available.

Cleft palate, treatment and complications

2020 ◽  
Author(s):  
Ali Davari Heidar ◽  
Marzieh Jafari ◽  
Hamed Zandi Esfahani
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Clinical Manifestations ◽  
Severe Form ◽  
Velopharyngeal Insufficiency ◽  
Care Clinic ◽  
Age At Surgery ◽  
Speech Assessment

Introduction:  The purpose of this study is to determine the incidence of velopharyngeal insufficiency (VPI), fistulae and recurrence development in patients seen by the Isfahan Cleft Care Clinic and also determine the association of gender, age at repair, and cleft type with the incidence of each. Methods and materials: In this retrospective study, 320 children who had undergone a primary cleft palate surgery and who had come to the Cleft lip and palate in Isfahan in 2010-2017 were studied based on the medical records and Information about each patient. Then all patients were evaluated by standard speech assessment methods for severity of hypernasalitis and screened for clinical manifestations of fistula and recurrence. Results: According to the results of this study, the incidence of velopharyngeal insufficiency after initial repair was 78.1% and most of these patients had severe form. The results also showed that by increasing age at surgery also increased the intensity of velopharyngeal insufficiency, and the severity of this complication has nothing to do with gender. In the case of fistula and recurrence of cleft showed that, in patients who are undergoing the new procedure to be significantly less than other patients. Conclusion: According to the study, palatoplasty complications such as velopharyngeal insufficiency, fistula, and recurrence were less common in patients treated with microsurgery, Therefore, it can be concluded surgical repair of cleft palate should be performed before 12 months ages and in microsurgery methods. It seems that follow up of these patients after surgery for monitoring of speech complications is necessary.

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