Speech Development in Cleft Palate with and without Robin Sequence

Objective To evaluate the language, phonetic, and phonological skills at age 3 years of two groups of young children with a cleft palate, with different expressive language proficiency at 2 years of age. Design Two groups of children with a cleft palate with differing abilities in early expressive language skills were identified at age 2 years. Comparisons across groups were made over a range of speech and language measures at age 3 years. Participants Twenty children with cleft palate were allocated to two groups dependent on expressive language abilities at age 2 years. One group had normal language development, and the second group had been identified as having significantly delayed (8 to 12 months’ delay) expressive language development. Main Outcome Measures The children were assessed at 3 years of age using standardized assessments and spontaneous speech samples. Comparisons between the two groups were made on a range of language measures including comprehension, expressive language, and speech. Results Group differences were found on both language and speech abilities at age 3 years. Significant group differences were found in expressive language, percentage of consonants correct, phonetic inventory, and phonological process usage. The group with delayed early expressive language abilities at 2 years continued to have expressive language difficulties at 3 years of age and had more disordered speech development, compared with the nondelayed group. Conclusions A subgroup of children with a cleft palate was identified who exhibited delays in early expressive language and continued to have delayed language and disordered phonological patterns at a later age. Support for three possible etiologies including a structural/anatomical deficit, cognitive/linguistic delay, or language/phonological disorder are discussed.

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Cleft Palate

10.2310/ps.10026 ◽

2018 ◽

Author(s):

Oksana A Jackson ◽

Alison E Kaye ◽

David W Low

Keyword(s):

Cleft Palate ◽

Normal Function ◽

Speech Development ◽

Velopharyngeal Insufficiency ◽

Surgical Interventions ◽

Feeding Difficulties ◽

Oronasal Fistula ◽

Cleft Palate Repair ◽

Palate Repair ◽

Impaired Speech

A cleft of the palate represents one of the most common congenital anomalies of the craniofacial region. Palatal clefting can occur in combination with a cleft of the lip and alveolus or as an isolated finding and can vary significantly in severity. The intact palate is a structure that separates the oral and nasal cavities, and the function of the palate is to close off the nasal cavity during deglutition and to regulate the flow of air between the nose and mouth during speech production. An unrepaired cleft palate can thus result in nasal regurgitation of food and liquid, early feeding difficulties, and impaired speech development. The goals of surgical repair are to restore palatal integrity by closing the cleft defect and repairing the musculature to allow for normal function during speech. The secondary goal of cleft palate repair is to minimize deleterious effects on growth of the palate and face, which can be impacted by standard surgical interventions. This review describes two of the most commonly performed cleft palate repair techniques in use today, as well as highlighting special anatomic considerations, summarizing perioperative care, and reviewing postoperative complications and their management. This review contains 11 figures, 2 videos, 3 tables and 63 references Key words: cleft, cleft team, Furlow, orofacial, oronasal fistula, palatoplasty, speech, submucous cleft, velopharyngeal insufficiency

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The Hybrid Palatoplasty: A Preliminary Report

Canadian Journal of Plastic Surgery ◽

10.1177/229255039600400307 ◽

1996 ◽

Vol 4 (3) ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

David A Gillett ◽

Howard M Clarke

Keyword(s):

Postoperative Complications ◽

Cleft Palate ◽

Preliminary Report ◽

Speech Development ◽

Stable Point ◽

Standard Procedures

A composite technique was developed for repair of the complete unilateral cleft palate. Using a Veau type pushback on the cleft side simplified anterior closure, and the cleft hemipalate was lengthened. A von Langenbeck procedure on the noncleft side minimized anterior raw area and provided a stable point for fixation. Fourteen consecutive patients with unilateral complete cleft palate underwent hybrid palatoplasties. There were no significant intra- or postoperative complications. No differences in speech development have been noted. The procedure was no more difficult than either of the standard procedures and offers technical and theoretical benefits.

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Methadone, Pierre Robin sequence and other congenital anomalies: case–control study

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2019-316804 ◽

2019 ◽

Vol 105 (2) ◽

pp. 151-157

Author(s):

Brian Cleary ◽

Maria Loane ◽

Marie-Claude Addor ◽

Ingeborg Barisic ◽

Hermien E K de Walle ◽

...

Keyword(s):

Cleft Palate ◽

Congenital Anomalies ◽

Population Based ◽

Pierre Robin Sequence ◽

Opioid Use ◽

Robin Sequence ◽

Risk Increase ◽

Increased Risk ◽

Pierre Robin ◽

Control Study

ObjectiveMethadone is a vital treatment for women with opioid use disorder in pregnancy. Previous reports suggested an association between methadone exposure and Pierre Robin sequence (PRS), a rare craniofacial anomaly. We assessed the association between gestational methadone exposure and PRS.Design/settingThis case-malformed control study used European Surveillance of Congenital Anomalies population-based registries in Ireland, the Netherlands, Italy, Switzerland, Croatia, Malta, Portugal, Germany, Wales, Norway and Spain, 1995–2011.PatientsCases included PRS based on International Classification of Disease (ICD), Ninth Edition-British Paediatric Association (BPA) code 75 603 or ICD, Tenth Edition-BPA code Q8708. Malformed controls were all non-PRS anomalies, excluding genetic conditions, among live births, fetal deaths from 20 weeks’ gestation and terminations of pregnancy for fetal anomalies. An exploratory analysis assessed the association between methadone exposure and other congenital anomalies (CAs) excluding PRS. Methadone exposure was ascertained from medical records and maternal interview.ResultsAmong 87 979 CA registrations, there were 127 methadone-exposed pregnancies and 336 PRS cases. There was an association between methadone exposure and PRS (OR adjusted for registry 12.3, 95% CI 5.7 to 26.8). In absolute terms, this association reflects a risk increase from approximately 1–12 cases per 10 000 births. A raised OR was found for cleft palate (adjusted OR 5.0, 95% CI 2.7 to 9.2).ConclusionsThese findings suggest that gestational methadone exposure is associated with PRS. The association may be explained by unmeasured confounding factors. The small increased risk of PRS in itself does not alter the risk–benefit balance for gestational methadone use. The association with cleft palate, a more common CA, should be assessed with independent data.

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