ABSTRACT
The purpose of this study was to describe perceptually the speech articulation, voice quality, and velopharyngeal competency of subjects with complete unilateral cleft lip and palate treated by the Zürich approach. The mean age of the 37 subjects was 10.5 years. Although only one subject had had secondary palatal management, no subject was rated as exhibiting a severe articulation or nasality problem. Subjects were rated as exhibiting adequate to marginal velopharyngeal competency 94.5 percent of the time, and the incidence of compensatory articulation errors was low. In comparison with other studies that evaluated the two-stage palatal repair, the Zürich approach appears to give the better results. The type of initial soft palate repair is probably the significant factor which contributes to the better speech of these subjects.
Subject(s)
Cleft Lip/surgery , Cleft Palate/surgery , Palate, Soft/physiology , Pharynx/physiology , Speech Intelligibility , Voice Quality , Voice , Adolescent , Child , Female , Humans , Male , Palatal Obturators , Phonetics , Speech Disorders/diagnosis , Switzerland , Velopharyngeal Insufficiency/diagnosisSubject(s)
Body Temperature Regulation , Circadian Rhythm , Feeding Behavior , Species Specificity , Animals , Male , Mice , Mice, Inbred C3H , Mice, Inbred C57BLSubject(s)
Cleft Lip/complications , Cleft Palate/complications , Maxillofacial Development , Adolescent , Child , Child, Preschool , Cleft Lip/physiopathology , Cleft Lip/surgery , Cleft Palate/physiopathology , Cleft Palate/surgery , Follow-Up Studies , Humans , Infant , Infant, Newborn , Longitudinal StudiesSubject(s)
Cleft Lip/therapy , Cleft Palate/therapy , Maxillofacial Development , Orthodontics, Corrective/methods , Palatal Obturators , Child , Child, Preschool , Cleft Lip/pathology , Cleft Lip/surgery , Cleft Palate/pathology , Cleft Palate/surgery , Dental Arch/pathology , Humans , Infant , Longitudinal Studies , Maxilla/pathologyABSTRACT
Two samples of complete cleft cases between five and seven years of age are compared (11 UCLP + 9 BCLP versus 21 UCLP + 12 BCLP). The same early orthopedic procedures were applied to all cases, but surgical management differed for the two groups: "classical" surgery (lip 3 months, palate 2--2 1/2 years) versus delayed conservative surgery (lip 6 months, soft palate 18 months, hard palate 6--8 years). It is evident that early maxillary orthopedic treatment is of little consequence for long-term development unless concomitant surgery complies with growth and functional requirements. In contrast to "classical" surgery, palatal closure in two steps is more favourable to skeletal growth and does not interfere to any relevant degree with speech development.
