Speech and Phonology in Swedish-Speaking 3-Year-Olds with Unilateral Complete Cleft Lip and Palate following Different Methods for Primary Palatal Surgery

2014 ◽  
Vol 51 (3) ◽  
pp. 274-282 ◽  
Author(s):  
Kristina Klintö ◽  
Henry Svensson ◽  
Anna Elander ◽  
Anette Lohmander
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Palatal Surgery

scholarly journals Speech in a consecutive series of children born with cleft lip and palate with and without syndromes and/or additional malformations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Klintö ◽  
Maria Sporre ◽  
Magnus Becker
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Consecutive Series ◽  
Total Group ◽  
One Stage ◽  
Audio Recordings ◽  
Bilateral Cleft Lip ◽  
Palatal Surgery ◽  
Group Comparisons

Abstract Background When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-). Methods One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed. Results In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group. Conclusions The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.

Speech in 5-Year-Olds With Cleft Palate With or Without Cleft Lip Treated With Primary Palatal Surgery With Muscle Reconstruction According to Sommerlad

2018 ◽  
Vol 55 (10) ◽  
pp. 1399-1408 ◽  
Author(s):  
Kristina Klintö ◽  
Evelina Falk ◽  
Sara Wilhelmsson ◽  
Björn Schönmeyr ◽  
Magnus Becker
Keyword(s):  
Cleft Palate ◽  
Normative Data ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Hospital ◽  
Air Leakage ◽  
Fistula Surgery ◽  
Audio Recordings ◽  
Velopharyngeal Function ◽  
Palatal Surgery

Objective: To evaluate speech in 5-year-olds with cleft palate with or without cleft lip (CP±L) treated with primary palatal surgery in 1 stage with muscle reconstruction according to Sommerlad at about 12 months of age. Design: Retrospective study. Setting: Primary care university hospital. Participants: Eight 5-year-olds with cleft soft palate (SP), 22 with cleft soft/hard palate (SHP), 33 with unilateral cleft lip and palate, and 17 with bilateral CLP (BCLP). Main Outcome Measures: Percent oral consonants correct (POCC), percent consonants correct adjusted for age (PCC-A), percent oral errors, percent nonoral errors, and variables related to velopharyngeal function were analyzed from assessments of audio recordings by 3 independent speech-language pathologists. Results: The median POCC was 75.4% (range: 22.7%-98.9%), median PCC-A 96.9% (range: 36.9%-100%), median percent oral errors 3.4% (range: 0%-40.7%), and median percent nonoral errors 0% (range: 0%-20%), with significantly poorer results in children with more extensive clefts. The SP group had significantly less occurrence of audible nasal air leakage than the SHP and the BCLP groups. Before age 5 years, 1.3% of the children underwent fistula surgery and 6.3% secondary speech improving surgery. At age 5 years, 15% of the total group was perceived as having incompetent velopharyngeal function. Conclusions: Speech was poorer in many children with more extensive clefts. Children with CP±L had poorer speech compared to normative data of peers without CP±L, but the results indicated relatively good speech compared to speech of children with CP±L in previous studies.

Early Palatal Changes after Initial Palatal Surgery in Children with Cleft Lip and Palate

1996 ◽  
Vol 33 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Gem J.C. Kramer ◽  
Jan B. Hoeksma ◽  
Birte Prahl-Andersen
Keyword(s):  
Soft Palate ◽  
Growth And Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Timing Of Surgery ◽  
Normal Children ◽  
Anterior Arch ◽  
Arch Width ◽  
Different Types ◽  
Palatal Surgery

Early palatal growth and development after primary palatal closure was studied in children with different types of cleft lip and palate (CLP). Palatal dimensions were measured on dental casts taken at fixed ages, from 9 months to 4 years of age. The results showed that soft and hard palatal closure in one stage had a significant impeding influence on posterior sagittal palatal growth compared to closure of the soft palate only. Timing of surgery possibly had a small temporary restrictive effect on posterior transverse palatal growth and development. Type and severity of the oral cleft had a significant effect on transverse palatal development and anterior sagittal dimensions. Anterior arch width was reduced in children with a complete unilateral (U) CLP or bilateral (B) CLP. The palates of the latter children had consistently larger anterior arch depths. Compared to normal children, palates of cleft children changed anteriorly from wider at 9 months of age to narrower at 4 years of age. Arch depths were smaller in cleft children except for anterior arch depths in children with complete BCLP.

scholarly journals On randomised trials of surgical timings for cleft palate repair

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Selena Young ◽  
Seng Teik Lee ◽  
David Machin ◽  
Say Beng Tan ◽  
Qingshu Lu
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Meta Analysis ◽  
The Other ◽  
International Strategy ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Different Ages ◽  
Palatal Surgery

Background: In this article we review randomised controlled trials (RCTs) comparing palatal surgery at different ages to examine their design features and quantify their conclusions. Method: A literature search of RCTs comparing surgical timings for cleft palate and/or lip repair from 1 January 2004 to 31 December 2013 was undertaken. This supplements an earlier systematic review of 62 RCTs in cleft lip and palate from 1 January 2004 to 31 December 2013 in English using the Cochrane Central Register of Controlled Trials, MEDLINE® and EMBASE with key words ‘cleft lip’ or ‘cleft palate’. Results: Four RCTs were identified, each comparing palate surgery at different lower (six, nine and 12 months) and upper (12, 18 and 36 months) ages with velopharyngeal competence (VPC) also at different ages (three, four, more than four or five years). These surgical and assessment age differences prevent a synthesis using meta-analysis techniques. Nevertheless, three RCTs indicate that VP function is more impaired with later surgery. Two ask questions about the type of surgery; one suggests that VPC is greater with Furlow palatoplasty than von Langenbeck surgery and the other that one technique appears to have better VPC at six months and the other at 12 months. Conclusion: The role of the timing of palatal surgery with respect to VPC remains unclear. We propose an international strategy that is designed to establish the optimal age for palatal surgery in infants requiring palate and/or lip repair.

scholarly journals Evaluation of Eustachian tube function in patients of cleft palate and effects of palatoplasty on these findings

2021 ◽  
Vol 7 (9) ◽  
pp. 1473
Author(s):  
Lalit Kochar ◽  
Deepak V. Chauhan ◽  
S. P. Bajaj ◽  
Akash Juneja
Keyword(s):  
Cleft Palate ◽  
Eustachian Tube ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Care Hospital ◽  
Eustachian Tube Function ◽  
Significant Difference ◽  
Tube Function ◽  
Isolated Cleft Palate ◽  
Palatal Surgery

<p class="abstract"><strong>Background:</strong> Isolated cleft palate and cleft palate and cleft lip patients have poor Eustachian tube function which results in hearing impairment that too in the speech formative years. Aim of study was to evaluate tympanometric findings in patient of cleft palate and effect of palatoplasty on both short term and long term postoperatively.</p><p class="abstract"><strong>Methods:</strong> The subjects consisted of patients attending the cleft lip and palate clinic. This was a combined clinic consisting of department of plastic surgery, department of ENT and department of dental surgery held every month at a tertiary care hospital in Delhi. Study consisted of three groups of patients namely preoperative group, postoperative group and pre-postoperative group.</p><p class="abstract"><strong>Results:</strong> No significant difference was observed in tympanometric abnormalities in cases of combined cleft lip and palate as compared to isolated cleft palate. After age of 5 months once changes of OME has set in there was no significant change in middle ear findings irrespective of palatal repair.</p><p class="abstract"><strong>Conclusions:</strong> There is a very high prevalence of otitis media with effusion in these patients. The changes do resolve spontaneously after age of seven, this perhaps is due to combined effect, growth, development and l maturity of Eustachian tube and palatal surgery rather than palatal surgery alone.</p><p> </p>

A Multicenter Retrospective 3D Study of Serial Complete Unilateral Cleft Lip and Palate and Complete Bilateral Cleft Lip and Palate Casts to Evaluate Treatment: Part 1—The Participating Institutions and Research Aims

1999 ◽  
Vol 36 (5) ◽  
pp. 413-424 ◽  
Author(s):  
Samuel Berkowitz
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
South Florida ◽  
University Hospital ◽  
Adult Size ◽  
Craniofacial Anomalies ◽  
Surgical Closure ◽  
Presurgical Orthopedics ◽  
Palatal Surgery

Objective: To compare the multicenter retrospective and prospective spaciotemporal (4D) serial analyses of complete unilateral (CUCLP) and complete bilateral (CBCLP) cleft lip and palate casts that had undergone different treatment procedures. The involved institutions are Miami Craniofacial Anomalies Foundation, South Florida Cleft Palate Clinic; University Hospital of Nijmegen Cleft Palate Center; Free University of Amsterdam Cleft Palate Center; Academic Hospital (Dijkzigt/Sophia) Rotterdam Cleft Palate Center; Center for Craniofacial Anomalies, University of Illinois College of Medicine; Cleft Palate Center, Sahigrenska University Hospital, Göteborg, Sweden; and Children's Memorial Medical Center, Northwestern University Cleft Palate Institute. Design: Using serial casts of the upper jaw and an electromechanical digitizer with special CadCam software (CadKey), the occlusal relationships and morphometric palatal growth changes that occur under the influence of presurgical orthopedics and various surgical procedures will be studied. It is anticipated that 3D geometric data extracted from serial casts will identify the important geometric palatal parameters present before cleft surgical closure, which will supply objective criteria for establishing a scientific basis for improved surgical therapy. This research study will test three hypotheses: (1) Conservative (varying the timing of surgical cleft closure according to the size of the cleft space) lip and palatal surgery will permit “catch-up” palatal growth and normalize palatal growth and development. (2) The amount of mucoperiosteal tissue relative to the size of the cleft space is important in determining the timing of palatal surgery, as it influences the degree of scarring and ultimately the palate's adult size and form. (3) Presurgical orthopedics (the use of appliances soon after birth) can stimulate palatal growth beyond its normal growth potential. Results: In a previous project and again after reviewing the data already collected during the first year of this study, it has been shown that incremental changes in size of palatal segments in CUCLP and CBCLP cases prior to surgery vary slightly. The CBCLP cases grow slightly faster than CUCLP cases before surgery, but growth of the CBCLP cases decreases in acceleration after surgery. Reasons for these differences will be determined when more cases are analyzed and subjected to biostatistical analysis.

Prediction of Early Palatal Growth and Development in Children with Cleft Lip and Palate

1996 ◽  
Vol 33 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Gem. J.C. Kramer ◽  
Jan B. Hoeksma ◽  
Birte Prahl-Andersen
Keyword(s):  
Growth Velocity ◽  
Growth And Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Arch Width ◽  
The Individual ◽  
The Relationship ◽  
Palatal Surgery ◽  
Average Development ◽  
Group 1

With the use of multilevel modeling of longitudinal data, the relationship between the developmental status of the palate at 4 years of age and early palatal growth and development from birth to 1.5 years of age was studied. A model to predict palatal depths and widths at 4 years of age was developed and tested. The sample consisted of 130 children with cleft lip and/or palate. They were divided into three groups according to surgical treatment; (1) no palatal surgery, (2) soft palatal surgery, and (3) soft and hard palatal surgery. Results showed that in groups 1 and 2, the total arch depth at 4 years of age is strongly related to the initial arch depth at birth. No or low correlations were found between palatal depth at 4 years of age and the growth velocity at birth. The anterior arch width in groups 2 and 3 at 4 years of age appeared to be strongly related to the early growth velocity. In group 1, a moderate correlation with the palatal width and growth velocity at birth was observed. The results of the individual predictions of arch depths and arch widths were reasonable to fair. It was concluded that prediction of individual arch variables at 4 years of age is possible, although within limits. Clinically this means that extreme development can be discriminated from more average development.

A Comparative Study of Prespeech Vocalizations in Two Groups of Toddlers with Cleft Palate and a Noncleft Group

2000 ◽  
Vol 37 (2) ◽  
pp. 172-178 ◽  
Author(s):  
Elisabeth Willadsen ◽  
Hans Enemark
Keyword(s):  
Mental Retardation ◽  
Retrospective Study ◽  
Cleft Palate ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Comparison Group ◽  
Place Of Articulation ◽  
Delayed Closure ◽  
Palatal Surgery

Objective This study examined the prelinguistic contoid (consonant-like) inventories of 14 children with unilateral cleft lip and palate (C-UCLP) at 13 months of age. The children had received primary veloplasty at 7 months of age and closure of the hard palate was performed at 3–5 years. The results of this investigation were compared to results previously reported for 19 children with cleft palate and 19 noncleft children at the age of 13 months. The children with clefts in that study received a two-stage palatal surgery. This surgical procedure was formerly used at our center and included closure of the lip and hard palate at 3 months of age and soft palate closure at 22 months of age. Design Retrospective study. Setting The participants were videorecorded in their homes during play with their mothers. The videotapes were transcribed independently by three trained speech pathologists. Patients Fourteen consecutive patients born with C-UCLP and no known mental retardation or associated syndromes served as subjects. Results The children who received delayed closure of the hard palate demonstrated a significantly richer variety of contoids in their prespeech vocalizations than the cleft children in the comparison group. Both groups of subjects with clefts had significantly fewer plosives in their contoid inventory than the noncleft group, and there was no difference regarding place of articulation between the group that received delayed closure of the hard palate and the noncleft group.

Speech in Unilateral and Bilateral Cleft Palate Patients from Stockholm

1993 ◽  
Vol 30 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Jonas Karling ◽  
Ola Larson ◽  
Rolf Leanderson ◽  
Gunilla Henningsson
Keyword(s):  
Surgical Treatment ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Primary Surgery ◽  
Bilateral Cleft Lip ◽  
Pharyngeal Flap ◽  
Palatal Surgery ◽  
Parental Information

The speech of 84 patients with complete unilateral cleft lip and palate and 19 patients with complete bilateral cleft lip and palate was judged by professional listeners and compared with a control group of 40 noncleft subjects. The unilateral cleft group consisted of two subgroups: one group of 45 patients, who were treated with presurgicat orthopedics before primary surgery, and one group of 39 patients, who were not. The speech of the patients and the noncleft subjects was tape recorded and randomly mixed prior to listener judgments. No significant differences in articulation or resonance were found between the subgroups of unilateral cleft patients. The results also indicated that the bilateral cleft patients had poorer speech and needed more speech therapy than the unilateral cleft patients. All cleft patients were found to have poorer speech than the noncleft subjects in spite of considerable speech therapy and complementary surgical treatment. This has resulted in a change in the Stockholm approach toward earlier palatal surgery, tailormade pharyngeal flap operations, and earlier parental information and treatment of articulatory deviations.

Sign in / Sign up

Export Citation Format

Share Document