[Universal scoring system for assessing speech function in patients with cleft palate at the stages of surgical treatment]. / Universal'naya ball'naya sistema otsenki rechevoi funktsii u patsientov s rasshchelinoi neba na etapakh khirurgicheskogo lecheniya.

OBJECTIVE: To develop a universal system for assessing the speech function in patients with congenital palatal cleft in the postoperative period. MATERIALS AND METHODS: A universal system for assessing the speech function for patients with a palatal cleft can be applied both after the primary operation of uranoplasty and for patients diagnosed with velopharyngeal insufficiency (VPI). The patient's speech is assessed according to the following criteria: defects in the pronunciation of consonants by place of articulation: labial, labiodental, lingual-dental, lingual-palatal, lingual-alveolar; speech breathing; tongue position; directed air stream; voicing disorders; The patient's is also evaluated for the following findings: hypernasality (reflected speech); hypernasality (spontaneous speech); hyponasality; pharyngeal reflex; audible nasal emission/turbulence; facial grimaces; speech intelligibility. The speech therapy and dental assessments are added to obtain a value characterizing the patient's condition: from 0 to 10 scoring indicates than only speech therapy correction is needed; from 11 to 18 - the decision on the necessity of surgical treatment is made by the surgeon together with the speech therapist, from 18 to 25 - surgical treatment is necessary with subsequent sessions with a speech therapist. RESULTS: With the help of this questionnaire, the operating surgeon can more accurately and objectively assess in dynamics the result of the surgical treatment, regardless of the results of speech therapy treatment in the postoperative period. The creation of this scoring system for speech assessment is aimed at objectivizing the results of uranoplasty and speech-improving operations. It allows the surgeon to compare the effectiveness of different surgical methods. CONCLUSION: The universal scoring system for assessing the state of speech function can be applied in the diagnosis of a patient with a palatal cleft both after the primary operation on the palate and after corrective surgical interventions. It allows monitoring progress and identifying dynamics in surgical and speech therapy treatment.

[Risk factors for teeth aplasia and hypoplasia in cleft lip and palate children].

The aim of the study was to assess the significance of environmental risk factors for teeth aplasia and hypoplasia in cleft lip and palate children. Two hundred and forty-seven cleft lip and palate (CLP) children were enrolled in the study including 105 (42.5%) with bilateral CLP and 57.5% with unilateral CLP. The mean age was 11.2±4.9 years. Teeth condition was assessed clinically and radiologically. The impact of risk factors for teeth anomalies was analyzed by retrospective data obtained from computer database (absence of preoperative orthopedic treatment, palatal defects after primary palatoplasty and type of primary procedures). Surgical trauma by early periosteoplasty (at the age of 3-4 months), excessive scarring and tissue traction due to absence of early orthopedic treatment and palatal defect were associated with significantly higher incidence of incisors hypoplasia (both developmental enamel defects and microdentia) and aplasia of central incisors not seen in the other study subgroups. Incisors aplasia and hypoplasia in CLP patients do not always have disembryogenic origin but may depend on external environmental factors, including surgical trauma.

[Echographic evaluation of anatomical bone structures peculiarities in children with two-sided cleft of upper lip and palate before and after early prosthetic treatment].

Ultrasound study of maxilla was performed in 74 patients with one-sided cleft of upper lip and palate (CULP) of the age from 1 month to 1.5 year. 49 patients with two-sided clefts got early prosthetic treatment with ultrasound investigation before the treatment beginning and after its completion. Cleft width, distance between alveolar process side fragments, height of alveolar process side fragments, angles of maxillary palatine processes origin from alveolar process side fragments, convergence angles of maxillary palatine processes and convergence angles of alveolar process side fragments were measured as well as intermaxillary bone mobility was determined. It was shown that echographic study in patients with CULP gave additional information that necessary for treatment planning and objective assessment of its results.

[Ultrasound study possibilities in evaluation of anatomical structures in children with congenital cleft of upper lip and palate].

Congenital cleft of upper lip and palate (CCULP) is one of the most widely spread and complicated developmental malformation of maxillofacial region, its frequency makes up for 16.4% of the total number of inherited defects. Ultrasound study (USS) let receive clinically significant information about anatomical structures peculiarities of upper lip, alveolar process and palate in patients with crest CCULP that could be important for surgical and prosthetic treatment planning and also significant for assessment of immediate and postponed treatment results. Verification of the received during surgical interventions and orthodontic manipulations data showed high diagnostic reliability of the USS results.