ABSTRACT
Use of nontoxic self-adhesive material is described to obturate residual hard palate fistulas. This material may be used during perceptual and aerodynamic speech assessments to evaluate speech distortion and the relative contributions of velopharyngeal port and fistula to nasal air leakage during speech. It may also be used as an interim obturator prior to surgical repair of a fistula.
Subject(s)
Fistula/therapy , Maxillary Diseases/therapy , Palatal Obturators , Palate , Child, Preschool , Cleft Palate/surgery , Cleft Palate/therapy , Fistula/surgery , Humans , Maxillary Diseases/surgery , Nose Diseases/surgery , Nose Diseases/therapy , Prosthesis Design , Speech Disorders/physiopathologyABSTRACT
Voice-quality (i.e., nasality) judgments are commonly used to evaluate the results of pharyngeal flap surgery. However, these are subjective judgments of questionable validity and reliability. This project was designed to systematically evaluate the outcome of pharyngeal flap surgery utilizing objective, quantifiable physiologic (pressure-flow) information. Thirty-one patients who had undergone pharyngeal flap surgery were selected. Pressure-flow measurements and perceptual judgments of speech were obtained following surgery. Results indicated that using pressure-flow criteria, only 52 percent of the outcomes were considered successful. Results also indicated that 35 percent of the cases were characterized by substantial nasopharyngeal airway obstruction. In the present study, these findings, along with the related perceptual phenomenon of denasality, were considered unsuccessful. Finally, results suggest that aerodynamic measurements can be used to assess other surgical techniques designed to correct velopharyngeal insufficiency.
Subject(s)
Pharynx/surgery , Respiration , Adolescent , Adult , Airway Resistance , Child , Child, Preschool , Cleft Palate/surgery , Evaluation Studies as Topic , Follow-Up Studies , Humans , Surgical FlapsABSTRACT
This study evaluated the effects of early prosthetic intervention for achieving normal articulation development in cleft palate patients. Early surgery is the preferred method of treatment to permit normal articulation development. Prosthetic management provides an alternative treatment to promote more normal articulation development when early surgery is not planned. It can be concluded that a prosthesis must be placed prior to development of meaningful speech if improved articulation development is to be achieved. Close cooperation among surgeon, speech pathologist, and prosthodontist is necessary to ensure timely surgical deferral and prosthetic treatment.
Subject(s)
Cleft Palate/therapy , Palatal Obturators , Speech Therapy/instrumentation , Child, Preschool , Humans , Infant , Prosthesis Design , Speech , Speech Disorders/prevention & controlABSTRACT
Speech production and age at palatal repair were investigated in 80 cleft palate children. Children whose palates were repaired prior to the onset of speech production demonstrated significantly better speech than those whose palates were repaired between 12 and 27 months of age. The supposition that earlier palatal repair results in more normal speech development was, in fact, demonstrated in these cases. Rather than using chronologic age alone as the deciding factor in determining timing of initial palatal repair, the stage of each child's phonemic development should be considered if maximum speech potential is to be achieved and if speech development is to parallel normal noncleft peers. Determining this stage of development through early speech and language evaluations, beginning at 6 months of age, thus becomes an essential component in the habilitation of children with cleft palate. Continued research is needed to ensure against giving the obtainment of early speech normalcy disproportionate emphasis over craniofacial growth considerations. To this end, continued cooperative research between surgeons and speech pathologists is imperative in order to base these important decisions on substantiated findings.
