ABSTRACT
Objective@#Velopharyngeal insufficiency (VPI) is a common postoperative sequela secondary tocleft palate. It could significantly impairpatients′living quality. Treatment of VPI includes surgery and speech therapy, but the reported success rates are inconsistent. A consensus in the literatures is needed, to guide procedure selection for patients with VPI.@*Methods@#This is a retrospective study on management options for patients with VPI.This study systematically introduces the assessment, management plan and treatment effect of VPI, in the Craniofacial center of Hospital Stomatology of Xi′an Jiaotong University.The challenges of VPI diagnosis and treatment with cleft palate are discussed in-depth.@*Results@#Most patients with VPI underwent evaluation and treatment (surgical or/and speech therapy) had speech improvement. The average value of hypernasality decreased from 3.67 before interventions to 1.57 after interventions.A multidisciplinary team using multi-modal to evaluate velopharyngeal function and speech. All patients had no bleeding, would dehiscence or fistula postoperatively. The difficulty of stimulability test was significantly reduced. Fourteen patients completed speech therapy, with the averaged treatments period of 3 months.@*Conclusions@#Speech pathologist is the manager of speech rehabilitation of cleft palate patients with VPI. The operation skill plays a key role in the treatment of VPI. Detailed diagnostic information is important for performing excellent surgical techniques. The cooperation of surgeon and speech pathologist, could be helpful to achieve the final speech rehabilitation.
ABSTRACT
Objective:To study the correlation between early postsurgery phonetic acquisition of speech stop and speech outcomes of young children.Methods:28 children with cleft palate were included in the study.An one-stage palatal repair procedure was per-formed by one surgeon for the children before the age of 1 8 months.Naming tests were used in the speech therapy room when the chil-dren were aged 23 months and 30 months.Stop consonant inventory number,percent correct consonants(PCC),percent correct man-ners(PCM)and percent correct places(PCP)were analyzed.Results:Number of stop consonant was significantly correlated with PCC,PCM and PCP at 24 and 30 months of age in the children.Coefficient of determination between stop consonant number and PCC was 0.535.Conclusion:Speech stop may be used as the “sensitive sound”for the analysis of speech development of the chinese children aged 2-3 years after cleft palate repair and as the individuation guideline to determine the best assessment and therapy time.
ABSTRACT
Objective:To evaluate the effect of presurgical nasal mode(PNM)combined with nasal diorthosis in the treatment of na-sal deformity and incomplete unilateral cleft lip(IUCL)in infants.Methods:35 infants with IUCL were treated by PNM followed by nasal diorthosis and cheiloplasty.The nasal asymmetry was analysed by measurments of nostrils height,nostrils width and nasal colu-mella angle skewness on the photographs at the initial visit(T0),pre-operation(T1),1 week after operation(T2),1 month after opera-tion(T3)and a year after operation(T4).The other 35 infants with IUCL without PNM treatment were served as the controls.Re-sults:Compared with the controls,the symmetry of nostrils height,nostrils width,nasal columella angle skewness in PNM treated children were significantly improved at T0-T1 and T1-T2(P ＜0.05).there was no significant difference at T2-T3 and T3-T4(P >0. 05).Conclusion:Nasal asymmetry can be improved by presurgical nasal mode treatment followed by preliminary nasal deformity di-orthosis and cheiloplasty.