scholarly journals Speech Outcome in Cleft Palate Patients After Soft Palatoplasty (Stage 1) in Two-Stage Palatoplasty Technique: A Review of Two Cases

1970 ◽  
Vol 1 (4) ◽  
Author(s):  
Eddy H Sutrisno ◽  
Luh K. Wahyuni ◽  
Kartika Lilisantosa
Keyword(s):  
Cleft Palate ◽  
Speech Intelligibility ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Two Stage ◽  
Old Patients ◽  
Speech Pathologist ◽  
Perceptual Assessment ◽  
Mild Impairment ◽  
One Year

Background: The challenge in palatoplasty is no longer a successful closure of the cleft palate but an optimal speech outcome without compromising maxillofacial growth. On the contrary, repairing cleft palate as soon as possible is recommended to improve speech. The surgeon proposed two-stage palatoplasty in early aged, range between 4 to 30 months. The delayed hard palate closure started approximately between the age of three years and one year after soft palatoplasty to avoid temporary retracted oral articulation of certain consonant. Patient and Methods: 11-months old and 9-months old patients with non-syndromic unilateral cleft lip and palate had undergone soft palatoplasty. Speech was examined as a perceptual assessment, using protocol in Craniomaxillofacial Center Cipto Mangunkusumo Hospital, in the age of 29 months by an experienced speech pathologist. Result: Patient 1 has mild hypernasality, adequate velopharyngeal competence, normal articulation pattern, phonation and speech intelligibility. Patient 2 has misarticulation pattern,which are omission or weak consonants, substitution of pharyngeal stop, mild to moderate hypernasality, mild impairment in speech intelligibility, and inadequate velopharyngeal competence.Summary: Speech outcome is influenced by intense speech practicing done by their parents. The patient can work on the misarticulation. We need further study to know the result of speech outcome in two stage palatoplasty.

scholarly journals Incidence of Bilateral Cleft Lip And Palate In A University Hospital Setting-A Retrospective Study

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 363-367
Author(s):  
Monisha K ◽  
Senthil Murugan P ◽  
Aravind Kumar
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Hospital Setting ◽  
Neck Region ◽  
University Hospital ◽  
High Prevalence ◽  
Bilateral Cleft Lip ◽  
Male Patients ◽  
One Year

Cleft lip and palate (CLP) is one of the most prevalent malformations occurring in the head and neck region. Cleft lip and palate is the second most birth defect in the US after club foot. The incidence of Cleft lip and cleft palate is also very common in Indian Population with the rate of 1 in 700 births approximately. In India, the main reason for the formation of Cleft Lip and cleft palate is consanguineous marriage due to less awareness among people. Cleft lip can be unilateral or bilateral and may involve or palate. Again it can be further classified as Complete or Incomplete cleft lip and /or Cleft palate. Most of the patients were deprived of treatment, mainly due to their unawareness and their lower status. Cleft patients need comprehensive, cleft care management. So the aim of this study is to find the incidence of bilateral cleft lip or palate in patients who reported toSaveetha Dental College and Hospital, Chennai. This study is done with 76 patients40 males, 36 females)who visited a Saveetha Dental College during one year between June 2019-April 2020. All available data were extracted from patients case sheets and results were obtained through SPSS analysis. In this study, we observed that 90.5 % of patients reported with unilateral cleft lip and palate, where only 9.1% of patients reported with bilateral cases. Males were having high prevalence with 52.6 % and females 47.4%. conclusion, male patients had higher cleft lip and palate compared to females. The incidence of bilateral cases seen among cleft lip and palate is fewer in males.

scholarly journals Effect of Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) on Compensatory Articulation in Children With Cleft Palate/Lip

2019 ◽  
Vol 6 ◽  
pp. 2333794X1985141 ◽  
Author(s):  
Raúl Herreras Mercado ◽  
Kenneth Simpson ◽  
Kristen H. Bellom-Rohrbacher
Keyword(s):  
Cleft Palate ◽  
Speech Intelligibility ◽  
Cleft Lip ◽  
Sound Production ◽  
Cleft Lip And Palate ◽  
Speech Disorders ◽  
Outpatient Rehabilitation ◽  
Single Subject ◽  
Positive Effects ◽  
Cleft Palate Speech

Objective. This investigation researched the effectiveness of the PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) method to address compensatory articulation errors in children with cleft palate. Design. Single-subject AB multiple baselines across participants and behaviors. Setting. Pediatric outpatient rehabilitation department in a local hospital in a metropolitan city. Participants. The investigation consisted of 3 participants (ages = 4:4 to 12:8) born with bilateral complete cleft lip and palate. All participants underwent several reconstructive surgeries to repair their lips and palates. Interventions. The PROMPT treatment was provided for 45 minutes 3 times a week for 4 weeks (3 weeks for Participant 2). Main Outcome Measure. Therapy sessions addressed anterior lingual speech motor phonemes across 3 tiers (syllables, words, and phrases). Results. Direct visual observation of data obtained throughout this investigation indicate potential positive effects and significant correlation between improvements in sound production at 3 tiers and the implementation of the PROMPT technique. Speech intelligibility was judged by 3 blinded listeners who were unfamiliar with children with speech disorders or with cleft palate speech. All listeners identified and judged improvement in overall speech intelligibility over the course of this investigation. Listeners examined speech samples selected from sessions 3, 6, 9, and 12. Conclusion. The findings in this investigation provide a potential relationship on the effectiveness of the PROMPT method and attainment of accurate speech productions in children with cleft palate producing compensatory articulation errors, resulting in improvement in overall speech intelligibility.

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

Speech Intelligibility of Patients with Cleft Lip and Palate after Placement of Speech Prosthesis

2007 ◽  
Vol 44 (6) ◽  
pp. 635-641 ◽  
Author(s):  
João Henrique Nogueira Pinto ◽  
Giseleda Silva Dalben ◽  
Maria Inês Pegoraro-Krook
Keyword(s):  
Cleft Palate ◽  
Speech Intelligibility ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Velopharyngeal Insufficiency ◽  
Cross Sectional ◽  
Before And After ◽  
Dental Needs

Objective: To evaluate the speech intelligibility of patients with clefts before and after placement of a speech prosthesis. Design: Cross-sectional. Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, Brazil. Patients: Twenty-seven patients with unoperated cleft palate or operated cleft palate presenting with velopharyngeal insufficiency (VPI) after primary palatoplasty, treated with speech prosthesis, aged 8 to 63 years. Interventions: Patients were fitted with palatopharyngeal obturators or pharyngeal bulbs, suitable to their dental needs. Five speech-language pathologists blindly evaluated speech samples of the patients with and without the prosthesis. Main Outcome Measures: Classification of speech samples according to a scoring system developed for speech intelligibility problems: 1 (normal), 2 (mild), 3 (mild to moderate), 4 (moderate), 5 (moderate to severe), and 6 (severe). Results were evaluated by the calculation of means of all judges for each patient in both situations. Results: The judges presented significant agreement (W = .789, p < .01). Speech intelligibility was significantly better after placement of the prosthesis for both unoperated patients (Z = 1.93, p = .02) and operated patients with VPI after primary palatoplasty (Z = 1.78, p = .03). Conclusions: Speech intelligibility may be improved by rehabilitation of patients with cleft palate using a speech prosthesis. Speech therapy is needed to eliminate any compensatory articulation productions developed prior to prosthetic management.

scholarly journals Speech Outcome Evaluation Of Cleft Palate Patients Underwent Palatoplasty In Plastic Surgery Division Cipto Mangunkusumo Hospital Indonesia

2018 ◽  
Vol 5 (1) ◽  
pp. 160-170
Author(s):  
Prasetyanugraheni Kreshanti ◽  
Vania Aramita Sari ◽  
Grace Wangge ◽  
Luh Karunia Wahyuni
Keyword(s):  
Initial Data ◽  
Cleft Palate ◽  
Speech Intelligibility ◽  
Cross Sectional Study ◽  
Current Data ◽  
Outcome Evaluation ◽  
Cross Sectional ◽  
Speech Pathologist ◽  
Perceptual Assessment

  Background: Speech is the primary goal of palatoplasty, however, there is no current data available about the long term speech evaluation after palatoplasty in our hospital which is the national referral hospital that has the only cleft craniofacial center in Indonesia. The initial data of speech outcome is required for further research which assessment should be standardized and applicable to Indonesian children that mostly speak bahasa. This study aims to get initial data by evaluating speech outcome of patients that underwent palatoplasty with adapted perceptual assessment words in Indonesian language, and describe factors influencing speech. Method: This research is a cross-sectional study to evaluate speech outcome of patients underwent palatoplasty in Cipto Mangunkusumo Hospital from October 2010–December 2012 conducted from December 2017 – July 2018. Result: Total 23 samples were measured for articulation rating where 17 (74%) patients had normal production of majority of phonemes, while there were 6 (26%) patients had predominantly distortion of phonemes. The hypernasality rating were normal in 12 (52%) patients, mild in 5 (22%) patients and moderate in 6 (26%) patients. The speech intelligibility rating were dominantly normal which all speech is understood in 17 (74%) patients and the rest of 6 (26%) patients were listeners attention needed. The velopharyngeal competence were good in 16 (70%) patients, fair in 1 (4%) patients and poor in 6 (26%) patients. Conclusion: Management of cleft palate patients will be achieved by well integrated services including speech pathologist and orthodontist. By giving the long term follow up to the patients, the optimal outcomes will be achieved. This research can be used as a reference for speech outcome evaluation in cleft palate patients in Indonesia.

scholarly journals Considerations Regarding Age at Surgery and Fistula Incidence Using One- and Two-stage Closure for Cleft Palate

2013 ◽  
Vol 59 (6) ◽  
pp. 302-305 ◽  
Author(s):  
Stoicescu Simona ◽  
Enescu Dm
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Techniques ◽  
Fistula Formation ◽  
Two Stage ◽  
One Stage ◽  
Age At Surgery ◽  
Cleft Palate Repair ◽  
Palate Repair

Abstract Introduction: Although cleft lip and palate (CLP) is one of the most common congenital malformations, occurring in 1 in 700 live births, there is still no generally accepted treatment protocol. Numerous surgical techniques have been described for cleft palate repair; these techniques can be divided into one-stage (one operation) cleft palate repair and two-stage cleft palate closure. The aim of this study is to present our cleft palate team experience in using the two-stage cleft palate closure and the clinical outcomes in terms of oronasal fistula rate. Material and methods: A retrospective analysis was performed on medical records of 80 patients who underwent palate repair over a five-year period, from 2008 to 2012. All cleft palate patients were incorporated. Information on patient’s gender, cleft type, age at repair, one- or two-stage cleft palate repair were collected and analyzed. Results: Fifty-three (66%) and twenty-seven (34%) patients underwent two-stage and one-stage repair, respectively. According to Veau classification, more than 60% of them were Veau III and IV, associating cleft lip to cleft palate. Fistula occurred in 34% of the two-stage repairs versus 7% of one-stage repairs, with an overall incidence of 24%. Conclusions: Our study has shown that a two-stage cleft palate closure has a higher rate of fistula formation when compared with the one-stage repair. Two-stage repair is the protocol of choice in wide complete cleft lip and palate cases, while one-stage procedure is a good option for cleft palate alone, or some specific cleft lip and palate cases (narrow cleft palate, older age at surgery)

scholarly journals The Role of the Velopharyngeal Sphincter in the Speech of Patients with Cleft Palate or Cleft Lip and Palate Using Perceptual Methods

2016 ◽  
Vol 4 (4) ◽  
pp. 674-679 ◽  
Author(s):  
Tatjana Georgievska-Jancheska ◽  
Juliana Gjorgova ◽  
Mirjana Popovska
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Speech Disorders ◽  
Main Role ◽  
Probable Nature ◽  
Perceptual Assessment ◽  
Experimental Group ◽  
Insight Into

BACKGROUND: The velopharyngeal sphincter (VPS) plays the main role in speech formation. The cleft palate, due to the damage of the soft palate, leads to dysfunction of the velopharyngeal sphincter thus causing speech disorder.AIM: To establish a link between the nasal air escape and the perceptual symptoms in the speech of patients with cleft palate or cleft lip and palate using auditory-visual perceptual procedures for determining the influence the velopharyngeal dysfunction has on speech.MATERIAL AND METHODS: Twenty patients with speech disorders, out of which 10 have cleft palate or cleft lip and palate (experimental group), participated in the perceptual assessment by means of Czermak mirror fogging test for assessing the nasal air escape and Pittsburgh Weighted Speech Scale (PWSS) for assessing the probable nature of the velopharyngeal sphincter.RESULTS: The respondents with a considerable nasal air escape have a higher velopharyngeal inability, that is, probably incompetent nature of the velopharyngeal sphincter. There is a strong correlation between the nasal air escape and the probable nature of the velopharyngeal sphincter (the coefficient of linear correlation r = 0.9756). The calculated р-value is р = 0.000002.CONCLUSION: The perceptual speech symptoms and the nasal air escape provide unique insight into the state and role the velopharyngeal sphincter has in speech.

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