scholarly journals THE SPEECH SOUND ERRORS AND LITERACY SKILLS IN CHILDREN WITH OROFACIAL CLEFTS

2021 ◽  
Vol 71 (6) ◽  
pp. 1976-80
Author(s):  
Arooj Karim Khan ◽  
Aasma Yousaf ◽  
Sharmeen Aslam Tarer ◽  
Rukhsana Kausar
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Writing Skills ◽  
Speech Sound ◽  
Sampling Strategy ◽  
Literacy Skills ◽  
P Value ◽  
Orofacial Clefts ◽  
Cross Sectional

Objective: To investigate the speech sound errors and literacy skills in children with orofacial clefts (cleft palate& cleft lip and palate). Study Design: Comparative cross-sectional study. Place and Duration of Study: Centre for Clinical Psychology, University of the Punjab, Lahore, from Mar 2016 to Feb 2017. Methodology: A sample of 42 participants (cleft lip & palate: n=18 and cleft palate: n=24) was collected. Two stage sampling strategy was used. Each child was individually screened through Slosson intelligence test revised checklist of orofacial cleft and diagnostic statistical Manual-V checklist. Then children were provided with assessment measures which included demographic informational questionnaire, community developed VPI Screener, word list for articulation and phonological processes, annual status of education report (ASER) and curriculum-based measurement (Written Expression). Manual SODA (substitution, omission, distortion and addition) analysis was done to know about the type of speech sound errors. Results: Independent sample t-test was used to compare the differences of speech sound errors (52.11 ± 25.08), (47.29 ± 25.38), reading skills (3.67 ± 1.14), (3.75 ± 1.26) and writing skills (14.61 ± 13.49), (25.14 ± 29.16) in cleft lip & palate and cleft palate respectively, indicated that there were no differences; with p-value: p=0.54, 0.83, 0.13. Conclusion: Results indicated no significant differences in speech sound errors, reading, writing skills and resonance between children with cleft lip & palate and cleft palate.

Morphological Presentation of Orofacial Clefts: An Epidemiological Study of 5004 Patients in a Tertiary Care Hospital of Central India

2021 ◽  
pp. 105566562110577
Author(s):  
Jaideep Singh Chauhan ◽  
Sarwpriya Sharma
Keyword(s):  
Cleft Palate ◽  
Epidemiological Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Tertiary Care ◽  
Central India ◽  
Care Hospital ◽  
Orofacial Clefts ◽  
Chi Square ◽  
The Right

Objective: To analyse the morphological presentation of orofacial clefts, gender, syndromes and systemic anomalies associated with them. Design: This was an epidemiological study performed in the patients who were registered for cleft lip and palate surgeries in our centre. The data was evaluated both retrospectively as well as prospectively. Patients/ Participants: The patients registered from November 2006 to April 2021 were studied. Out of 5276 patients, data of 5004 cases were analysed, rest 272 patients were excluded due to lack of information. Statistical analysis and Chi square test were applied. Results: Cleft deformities were more common in males than females. Cleft lip with palate was the commonest phenotype (52.2%). It was followed by isolated cleft lip (22.9%), isolated cleft palate (22.1%), rare clefts (1.62%) and syndromic clefts (1.18%). Unilateral variants were more frequent than bilateral. In unilateral, left side was more common than the right side. Among bilateral, most of the cases had premaxillary protrusion. In the present study, 3.46% of all the patients had associated anomalies affecting their other organs. Less common cleft phenotypes like microform cleft lip and submucous cleft palate ± bifid uvula showed frequency of 0.62% and 0.64% respectively. Conclusion: Thorough examination of cleft deformity should be done as it may appear as an isolated deformity or part of a syndrome and have associated systemic anomalies. This may help us to deliver comprehensive care to the patients and can prevent potential operative complications.

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.

Surgical Repair of Orofacial Clefts in North Kivu Province of Eastern Democratic Republic of Congo (DRC)

2020 ◽  
Vol 57 (11) ◽  
pp. 1314-1319
Author(s):  
Luc Malemo Kalisya ◽  
Jacques Fadhili Bake ◽  
Bake Elisee ◽  
Kavira Nyavandu ◽  
Robert Perry ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Democratic Republic ◽  
Cleft Lip And Palate ◽  
Surgical Repair ◽  
Democratic Republic Of Congo ◽  
Orofacial Clefts ◽  
Republic Of Congo ◽  
General Surgeons ◽  
North Kivu

Background: There is a high prevalence of orofacial clefts in low- and middle-income countries with significant unmet need, despite having 50% of the population younger than 18 years in countries such as the Democratic Republic of Congo (DRC). The purpose of this article is to report on the experience of general surgeons with orofacial clefts at a single institution. Methods: This is a retrospective study of patients treated for cleft lip/palate in the province of North Kivu, DRC between 2008 and 2017. Results: A total of 1112 procedures (122/year) were performed. All procedures were performed by general surgeons following training by an international nongovernmental aid organization. A total of 59.2% of patients were male and the median age was 3.4 years (interquartile range: 0.7-13 years). Average distance from surgical center to patient location was 242.6 km (range: 2-1375 km) with outreach performed for distances >200 kms. A majority (82.1%) of patients received general anesthesia (GA) with significant differences in use of GA, age, weight, and length of stay by major orofacial cleft category. Of the 1112 patients, 86.1% were reported to have cleft lip alone, 10.5% had cleft lip and palate, and 3.4% cleft palate alone. Despite this, only 5.3% of patients underwent surgical repair of cleft palate. Conclusions: Multiple factors including malnutrition, risk of bleeding, procedural complexity, and cosmetic results may contribute to the distribution of procedures performed where most cleft palates are not treated. Based on previously published estimates, unmet needs and social burden of cleft lip and palate are high in the DRC.

scholarly journals Receptive and Expressive Vocabulary Skills and Their Correlates in Mandarin-Speaking Infants with Unrepaired Cleft Lip and/or Palate

2020 ◽  
Vol 17 (9) ◽  
pp. 3015
Author(s):  
Si-Wei Ma ◽  
Li Lu ◽  
Ting-Ting Zhang ◽  
Dan-Tong Zhao ◽  
Bin-Ting Yang ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Short Form ◽  
Cross Sectional Study ◽  
Receptive Vocabulary ◽  
Expressive Vocabulary ◽  
Cross Sectional ◽  
Vocabulary Skills ◽  
Communicative Development

Background: Vocabulary skills in infants with cleft lip and/or palate (CL/P) are related to various factors. They remain underexplored among Mandarin-speaking infants with CL/P. This study identified receptive and expressive vocabulary skills among Mandarin-speaking infants with unrepaired CL/P prior to cleft palate surgery and their associated factors. Methods: This is a cross-sectional study involving patients at the Cleft Lip and Palate Center of the Stomatological Hospital of Xi’an Jiaotong University between July 2017 and December 2018. The Putonghua Communicative Development Inventories-Short Form (PCDI-SF) was used to assess early vocabulary skills. Results: A total of 134 children aged 9–16 months prior to cleft palate surgery were included in the study. The prevalences of delays in receptive and expressive vocabulary skills were 72.39% (95% CI: 64.00–79.76%) and 85.07% (95% CI: 77.89–90.64%), respectively. Multiple logistic regression identified that children aged 11–13 months (OR = 6.46, 95% CI: 1.76–23.76) and 14–16 months (OR = 24.32, 95% CI: 3.86–153.05), and those with hard/soft cleft palate and soft cleft palate (HSCP/SCP) (OR = 5.63, 95% CI: 1.02–31.01) were more likely to be delayed in receptive vocabulary skills. Conclusions: Delays in vocabulary skills were common among Mandarin-speaking CL/P infants, and age was positively associated with impaired and lagging vocabulary skills. The findings suggest the necessity and importance of early and effective identification of CL/P, and early intervention programs and effective treatment are recommended for Chinese CL/P infants.

scholarly journals Incidence of Orofacial Clefts in Kumasi, Ghana

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
P. Agbenorku ◽  
M. Yore ◽  
K. A. Danso ◽  
C. Turpin
Keyword(s):  
Cleft Palate ◽  
Congenital Anomalies ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Orofacial Clefts ◽  
Female Ratio ◽  
Live Births ◽  
Male Female Ratio ◽  
Cleft Lip Palate ◽  
History Of

Background. Cleft lip and cleft palate are among the most common orofacial congenital anomalies. This study is to establish Orofacial Clefts Database for Kumasi, Ghana, with a view to extend it to other cities in future to obtain a national orofacial anomaly database. Methods. A descriptive prospective survey was carried out at eleven selected health facilities in Kumasi. Results. The total number of live births recorded was 27,449. Orofacial anomalies recorded were 36, giving an incidence of 1.31/1000 live births or 1 in 763 live births. The mean maternal age of cleft lip/palate babies was 29.85 years (range 18–40 years). The male : female ratio for the orofacial anomalies babies was 1.3 : 1; the male : female ratio was 0.5 : 1 in the cleft lip group, 1.3 : 1 in the cleft lip and palate group, and 4 : 1 in the cleft palate group. The majority of clefts were unilateral (69.4%, n=25), with females (n=14) outnumbering males (n=11). A family history of cleft was recorded with five babies (13.9%). Associated congenital anomalies were recorded in seven (19.4%) cleft lips and/or palates. Conclusion. The incidence of 1 in 763 live births found in this study indicates that cleft lip/palate is a common congenital anomaly in Kumasi.

scholarly journals Age of Individuals Undergoing Cleft Lip and Cleft Palate Surgeries in Nepal

2013 ◽  
Vol 52 (192) ◽  
Author(s):  
Shankar Man Rai ◽  
Kiran Nakarmi ◽  
Surendra Basnet ◽  
Pramila Shakya ◽  
Krishna Nagarkoti ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Cross Sectional ◽  
Remote Areas ◽  
Age At Surgery ◽  
The Right ◽  
The Impact

Introduction: Timely repair of cleft lip and palate maximises the benefits of surgery. Developing countries have large number of adults with unrepaired clefts. The impact of a cleft program can be determined by observing the trends of lower age at surgery. Public Health Concern Trust, Nepal has been providing a comprehensive nationwide cleft service since 1999. This study was conducted to see any change in the age at surgery. Methods: A retrospective cross sectional study was conducted to analyse the data of all the individuals’ age at primary cleft surgery from July 1999 to June 2010. Mean and median age of individuals as well as the proportion of individuals operated on at the right age in different years were calculated and compared. Results: The median age for cleft lip surgery decreased from 100 to 24 months. Similarly the median age for cleft palate surgery decreased from 70 to 28 months. Proportion of surgeries carried out in the recommended age also increased. A change in the policy of the program reaching out to more remote areas and removing the age barrier for surgery resulted in older adults receiving surgery and increased median age especially for cleft palate repairs. Conclusions: A nationwide cleft program for a decade had a small impact on age at surgery. There are still many individuals who are missing the ideal age for surgery. The program needs to reach more remote areas. This information will be useful for governmental as well as non-governmental organizations working in the area of clefts. Keywords: age; cleft lip; cleft palate; Nepal.    

scholarly journals Caracterización de los pacientes con labio y paladar hendido y de la atención brindada en el hospital infantil universitario de manizales (Colombia), 2010./Study of clinical and epidemiological characteristics of patients with lip and palate treated in th

2012 ◽  
Vol 12 (2) ◽  
pp. 190-198 ◽  
Author(s):  
Ingid Charry ◽  
Mónica lorena Aguirre ◽  
José jaime Castaño castrillón ◽  
Brenda juliana Gómez ◽  
Juliana Higuera ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Multidisciplinary Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Calidad De Vida ◽  
Epidemiological Characteristics

Objetivo: El labio y paladar hendido es la malformación más común de cabeza y cuello en el medio colombiano, es una patología multifactorial determinada por alteraciones genéticas y ambientales. Se da en uno de cada 900 nacidos vivos afectando a varones en una mayor proporción. El objetivo del presente estudio es registrar las características sociodemográficas, clínicas y de tratamiento de 118 pacientes con labioy paladar hendido atendidos en el Hospital Infantil Universitario “Rafael Henao Toro” de la ciudad de Manizales (Colombia).Materiales y Métodos: Estudio de corte transversal en pacientes que asistieron a la clínica de labio y paladar en el mencionado hospital.Resultados: Se encontró frecuencia del sexo masculino en un 55,1%, un 51,7% procedente del área urbana y en su mayoría de los estratos III y IV, la frecuencia más alta se presentó para labio y paladar hendido grado III con 36,4%. El esquema de tratamiento más utilizado fue la palatorrafia (63,6%) y la queiloplastia (69,5%).Conclusiones: La caracterización de los pacientes con labio y Paladar Hendido indica predominio por los pacientes con diagnóstico de labio y paladar hendido Grado III, igual distribución entre géneros, procedencia urbana en los cuales el estrato IV cuenta con la mayor frecuencia. Cabe destacar la importancia de un diagnóstico oportuno además un tratamiento multidisciplinario, que cuente con apoyo personal además del quirúrgico que se verá reflejado en una buena evolución y calidad de vida de los pacientes. Background: Cleft lip and cleft palate is the most common malformation of the headand neck of our environment, is a multifactorial disease determined by genetic andenvironmental factors. It occurs in one in every 900 live births, affecting males at agreater rate, today’s advances in terms of proposed treatment from the multidisciplinaryapproach, starting with a strict evaluation by pediatric to ensure that patients are in theright conditions to initiate surgical procedures.Materials and Methods: A cross sectional study. We recorded demographic characteristics,clinical and treatment of 118 patients who attended the lip and palate clinicat Children’s Hospital University of Manizales.Results: We found more frequently in males 55.1%, 51.7% from the urban area andmost of the layers III and IV, the highest incidence is presented for cleft lip and palategrade III in 36.4% The most commonly used treatment regimen was palate surgeryand cheiloplasty.Conclusions: The characterization of patients with cleft lip and cleft palate indicatespredominance for patients with cleft lip and palate grade III, gender equality, urbanhometown strata IV which has the highest frequency. Remarkable the importance ofearly diagnosis also appropriate multidisciplinary treatment, that has support in additionto the surgical staff will be reflected in a good performance and quality of life of patients

Nasal Airflow Patterns during the Velopharyngeal Closing Phase in Speech in Children with and without Cleft Palate

2001 ◽  
Vol 38 (4) ◽  
pp. 358-373 ◽  
Author(s):  
Hans Dotevall ◽  
Hasse Ejnell ◽  
Björn Bake
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Stop Consonant ◽  
Maximum Flow ◽  
University Hospital ◽  
Control Group ◽  
Consecutive Series ◽  
Nasal Airflow ◽  
Cross Sectional

Objectives: (1) To study the nasal airflow patterns during the velopharyngeal closing phase in speech produced by children with and without cleft palate. (2) To compare the nasal airflow patterns in bilabial, dental, and velar articulation in these children. Design: Prospective, cross-sectional study of a consecutive series of children with cleft palate referred for routine speech evaluation and controls. Setting: Sahlgrenska University Hospital, Göteborg, Sweden. Participants: Seventeen children with cleft lip and palate or cleft palate only and 22 controls aged 7 and 10 years. Method: Nasal airflow was transduced with a pneumotachograph attached to a nose mask and registered together with the acoustic speech signal. Sentences containing nasal-to-stop combinations in bilabial, dental, and velar articulatory positions were used. Main Outcomes Measures: The duration from peak to 5% nasal airflow, the maximum flow declination rate, and the nasal airflow at selected points in time during the transition from nasal-to-stop consonants. Results: In the cleft palate group, duration from peak to 5% nasal airflow was clearly longer than among the controls (p < .0001). The declination of airflow was slower (p < .006) and the rate of nasal airflow at the release of the stop consonant was higher (p < .004) in the cleft palate group. Differences between bilabial versus dental and velar articulation were found in the control group. Conclusion: Studies of the temporal and dynamic characteristics of the nasal airflow variations during speech appear potentially useful for the assessment of velopharyngeal function.

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 Analisis morfologi dan dimensi sella tursika pada pasien celah bibir langit-langit dan tanpa celah bibir langit-langit non sindromik usia 6-15 tahunAnalysis of morphology and dimensions of the sella turcica in patients with cleft palate and non-syndromic cleft palate aged 6-15 years

2021 ◽  
Vol 33 (2) ◽  
pp. 112
Author(s):  
Rudi Satria Darwis ◽  
Rifdah Triswidiyanti Zaahidah Abroor
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Hormone Secretion ◽  
Sella Turcica ◽  
T Test ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Kolmogorov Smirnov ◽  
Morphological Differences

Pendahuluan: Sella tursika adalah cekungan berbentuk pelana (saddle shaped) tulang sphenoid yang terletak pada fosa kranium media dan merupakan referensi anatomis yang penting pada analisis sefalometri. Morfologi dan dimensi sella tursika dapat dipengaruhi oleh kelenjar pituitari yang mengakibatkan gangguan regulasi sekresi kelenjar hormon,  dan/atau gangguan celah bibir dan langit-langit. Tujuan penelitian menganalisis perbedaan morfologi dan dimensi sella tursika pada pasien celah bibir langit-langit dan tanpa celah bibir langit-langit non sindromik usia 6-15 tahun. Metode: Penelitian ini merupakan studi cross sectional dengan purposive sampling pada 46 radiografi sefalometri lateral terstandarisasi yang terdiri dari 23 sampel pada masing-masing kelompok. Data dianalisis secara statistik menggunakan Kolmogorov Smirnov Z dan independent sample t-test. Hasil: Hasil penelitian menunjukkan morfologi dinding anterior oblique lebih banyak ditemukan pada pasien celah bibir langit-langit non sindromik, sedangkan morfologi normal lebih banyak ditemukan pada pasien tanpa celah bibir langit-langit (p=0,026). Terdapat perbedaan diameter dan kedalaman sella tursika antara kedua subjek, dan ditemukan bahwa pasien celah bibir langit-langit non sindromik memiliki rerata dimensi yang lebih kecil dibandingkan pasien tanpa celah bibir langit-langit (p=0,043 dan p=0,001). Simpulan: Terdapat perbedaan morfologi dan dimensi sela tursika berupa diameter dan kedalaman sela tursika yang lebih kecil pada pasien celah bibir langit-langit dibandingkan pasien tanpa celah bibir langit-langit non sindromik usia 6-15 tahun. ABSTRACTIntroduction: The sella turcica is a saddle-shaped depression of the sphenoid bone in the middle of the cranial fossa and is an essential anatomical reference in cephalometric analysis. The morphology and dimensions of the sella turcica can be influenced by the pituitary gland, impaired regulation of hormone secretion and cleft lip and palate disorders. This study was aimed to analyse the differences in the morphology and dimensions of the sella turcica in patients with cleft palate and non-syndromic cleft palate aged 6-15 years. Methods: This study was cross-sectional with purposive sampling on 46 standardised lateral cephalometric radiographs consisting of 23 samples in each group. Data were analysed statistically using Kolmogorov Smirnov Z and an independent sample t-test. Results: The results showed that the morphology of the anterior oblique wall was more commonly found in non-syndromic cleft lip and palate patients, while normal morphology was found more in patients without cleft palate (p=0.026). There were differences in the diameter and depth of the sella turcica between the two subjects, and it was found that non-syndromic cleft lip and palate patients had a smaller mean dimension than patients without cleft palate (p=0.043 and p=0.001). Conclusions: There are morphological differences and dimensions of the sella turcica in the form of a smaller diameter and depth of the cleft palate in patients with cleft palate compared to patients without non-syndromic cleft palate aged 6-15 years.

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