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.

scholarly journals Corelation Of Parents’ Profiles Of Children With Late Cleft Repair In Surabaya Cleft Lip And Palate Centre (January 2015 – December 2017)

2021 ◽  
Vol 5 (1) ◽  
pp. 18
Author(s):  
Laras Puspita Ningrum ◽  
Iswinarno Doso Saputro ◽  
Lobredia Zarasade
Keyword(s):  
Cleft Palate ◽  
Primary Care Physicians ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Speech Disorders ◽  
Education Level ◽  
Optimal Time ◽  
Cross Sectional ◽  
Cleft Palate Repair ◽  
Palate Repair

Background : Optimal time of  Cleft palate repair is during the 10 to 12  month of age. In this time produce far natural results in terms of speech because it enabled the maturation of scar tissue postoperatively. The soft palate must function properly before the patient starts learning to talk, otherwise speech disorders such as persistent rhinolalia aperta might arise. In pediatric patients, the role of parents is very important on adherence to therapy.Methods: This is a cross-sectional study. The first study group was parents of patients who had surgical repair before two years old and the second group was the parents of patients who had repair after two years old. We compared age, monthly income, education level, number of children, and residential distance from Surabaya of the two groups.Results : The data of this study were obtained from the medical records of patients with cleft lip surgery at CLP Center Surabaya in 2015th – 2017th with total of 358 patients, 172 were female and 186 were male. 52 patients with delayed cleft palate surgery. Patients’ parents in both groups were mostly 31-40 years old, were high school graduated, has one child, earned less than 1.5 million rupiah a month, and lived less than 100 kms from Surabaya. From the statistical results, parent’s income has the strongest correlation with the patient’s age in cleft palate surgery (-2.7). A negative coefficient means that the less parent’s income, the more patient likely had delayed cleft palate surgery. While other factors found weak and very weak correlations.Conclusions: The results form patient's parents' interview, concluded that besides economic factors, the lack of information cleft palate treatment is the key factors that contributed to the delay of cleft palate repair. The education level does not affect the delay in cleft palate surgery, because even in high educated parents, sometimes they don’t understand the stages of cleft lip and palate treatment. This study emphasized the necessity to educate about the stages of surgery by primary care physicians, to minimize delays.

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.

Speech Evaluation and Treatment for Patients With Cleft Palate

2003 ◽  
Vol 12 (1) ◽  
pp. 103-109 ◽  
Author(s):  
David P. Kuehn ◽  
Lisa J. Henne
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Speech Disorders ◽  
Speech Evaluation ◽  
Surgical Mission ◽  
Concise Guide

This compendium has been written in conjunction with a cleft lip and palate surgical mission that took place in Villahermosa, Mexico, February 4–9, 2001. Fifty children, 10 per day, received lip or palate surgery. This report, available in both English and Spanish, is intended as a practical and concise guide to basic aspects of evaluation and treatment of speech disorders associated with cleft palate. More detailed and comprehensive sources dealing with this topic are available and have been reviewed by D. P. Kuehn and K. T. Moller (2000).

scholarly journals Assessment of role of consanguinity in formation of cleft lip and cleft palate

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1027-1031
Author(s):  
Joshini Shanmugam ◽  
Senthil Murugan P ◽  
Suresh V
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Chi Square ◽  
Consanguineous Marriages ◽  
Cleft Lip Palate ◽  
Chi Square Test ◽  
History Of ◽  
Autosomal Recessive Diseases

Consanguinity is considered a significant factor in autosomal recessive diseases; it has also been associated with congenital anomalies such as hydrocephalus, polydactilia and Cleft Lip and Palate deformities. The risk of congenital conditions is higher in subjects born of first degree consanguineous parents compared with those of non-consanguineous marriages. The aim of this study is to evaluate the prevalence of consanguinity with formation of cleft lip/ cleft palate formation in Tamil, Telugu population. This is a retrospective study. The details of 86,000 patient records were reviewed and analysed, out of which 76 patients who had undergone surgical treatment for cleft lip and cleft palate deformities between June 2019 to march 2020 were included in this study. The details like age, gender, family history and cleft diagnosis were evaluated and entered in SPSS and analysed through a chi-square test. It was observed that 11% of patients reported with history of consanguineous marriages which was associated with formation of cleft lip/palate. Within the limits of the study, it was concluded that consanguinity had a significant role in formation of cleft lip/cleft palate.

scholarly journals The Relationship between the Type of Cleft and Nasal Air Emission in Speech of Children with Cleft Palate or Cleft Lip and Palate

2019 ◽  
Vol 7 (3) ◽  
pp. 352-357
Author(s):  
Tatjana Georgievska-Jancheska
Keyword(s):  
Cleft Palate ◽  
Speech Production ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Velopharyngeal Insufficiency ◽  
P Value ◽  
Air Emission ◽  
Perceptual Assessment ◽  
Assessment Procedures ◽  
The Relationship

BACKGROUND: Cleft palate, due to damage of the soft palate, leads to dysfunction, i.e., inappropriate closure of the velopharynx during speech production, thus resulting in velopharyngeal insufficiency which characterises with hypernasal speech and nasal air loss/emission during speech production. AIM: To establish the relationship between the type of cleft according to the Veau classification and the degree of nasal air emission in the speech of patients with cleft using auditory-visual perceptual assessment procedures. MATERIAL AND METHODS: A group of 40 patients with irregular speech aged 4 to 7, out of which 20 with cleft palate or cleft lip and palate, participated in the research. The Veau classification was used to classify the cleft severity, while an indirect instrumental examination was conducted with the See-Scape instrument to detect nasal air emission during the speech. RESULTS: The respondents with cleft palate or cleft lip and palate of higher Veau class had a greater degree of nasal air emission during the speech. There is a positive, statistically significant correlation between the results obtained with the Veau classification of cleft lip and palate, and the degree of nasal air emission. The value of Spearman’s coefficient of correlation is R = 0.46, and the calculated p-value is p = 0.04. CONCLUSION: A more severe cleft type is associated with an increased degree of nasal air emission during the speech, and vice versa.

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.

Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate

2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
English Speaking ◽  
And Gender ◽  
Early Primary ◽  
Velopharyngeal Function ◽  
Normal Speech

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.

scholarly journals Atypical Outcomes of Nasal and Lip Appearance After Unilateral Cleft Lip Repair: Judgment by Professionals, Patients, and Laypeople

2021 ◽  
pp. 105566562098280
Author(s):  
Robin A. Tan ◽  
Frans J. Mulder ◽  
Roderic M. F. Schwirtz ◽  
David G. M. Mosmuller ◽  
Henrica C. W. De Vet ◽  
...  
Keyword(s):  
Analysis Of Variance ◽  
Online Survey ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Old Patients ◽  
Rank Score ◽  
Cleft Lip Repair ◽  
Typical Appearance ◽  
Unilateral Cleft Lip Repair ◽  
Insight Into

Objective: To gain more insight into the assessment of “atypical” nasal and lip appearance outcomes compared to “typical” appearance outcomes after unilateral cleft lip and palate (UCLP) repair, when judged by professionals, patients with repaired UCLP, and laypeople. Design: An online survey containing 3 series of photographs with various degrees of “typical” and “atypical” nasal and lip appearance outcomes after UCLP repair was sent to 30 professionals, 30 patients with repaired UCLP, and 50 laypeople in 2 countries. Participants were instructed to rank the photographs from excellent to poor based on overall appearance. Mean rank positions of photographs were analyzed and differences in mean rank score between “typical” and “atypical” results were assessed using a T-test. Agreement of ranking between the 3 groups was assessed with an analysis of variance analysis. Setting: Amsterdam UMC, location VUmc, Netherlands and Boston Children’s Hospital, Boston, USA. Patients: Photographs of 6- to 18-year-old patients with repaired UCLP. Results: “Atypical” appearance outcomes were ranked significantly less favorably (small nostril: P = 0.00; low vermillion border: P = 0.02; whistling deformity: P = 0.00) compared to “typical” outcomes. Difference between professionals, patients and laypeople in rank positioning the photographs was not statistically significant ( P = 0.89). Conclusions: Noses with a smaller nostril and lips containing a whistling deformity were perceived as poorer outcome compared to the “typical” results. Professionals, patients, and laypeople are in agreement when assessing these outcomes.

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.

Sign in / Sign up

Export Citation Format

Share Document