Speech Task Force and Quality of Life after Surgery in Children with Cleft Lip and Palate: Limitation of Professionals.

Background Shortage of speech and language therapists results in lack of speech services. The aims of this study were to find the effectiveness of a combination speech therapy model at Level IV: General speech and language pathologist (GSLP) and Level V: Specific speech and language pathologist (SSLP) in reduction of the number of articulation errors and promotion the quality of life (QoL) for children with cleft palate with or without cleft lip (CP ± L). Methods Fifteen children with CP ± L, aged 4 years 1 month to 10 years 9 months (median = 76 months; minimum:maximum = 49:129 months) were enrolled in this study. Pre- and post-assessment included oral peripheral examination; articulation tests via Articulation Screening Test, Thai Universal Parameters of Speech Outcomes for People with Cleft Palate, Hearing Evaluation, The World Health Organization Quality of Life Brief_Thai (WHOQOL-BRIEF-THAI) version questionnaire for QoL were performed. Speech therapy included a 3-day intensive speech camp by SSLP, five 30-minute speech therapy sessions by a GSLP, and five 1-day follow-up speech camps by SSLP that provided four 45-minute speech therapy sessions for each child. Results Post-articulation revealed statistically significant reduction of the numbers of articulation errors at word, sentence, and screening levels (median difference [MD] = 3, 95% confidence interval [CI] = 2-5; MD = 6, 95% CI = 4.5-8; MD = 2.25, 95% CI = 1.5-3, respectively) and improvement of QoL. Conclusion A speech task force consisting of a combination of Level IV: GSLP and Level V: SSLP could significantly reduce the number of articulation errors and promote QoL.

Myanmar Articulation, Resonation, Nasal Emission, and Nasal Turbulence Test: A Preliminary Study.

Background This article describes the development of the Myanmar Articulation, Resonation, Nasal Emission, and Nasal Turbulence test for children with cleft lip and palate (CLP), and evaluation of its validity and reliability. Methods It was created by three Thai researchers and a Burmese research assistant based on Burmese phonology. The content validity was evaluated by six Burmese language experts. All test items were divided into three groups: high-pressure oral consonants, low-pressure oral consonants, and nasal consonants. Results All items (58-word and 32-phrase/sentence) gave an excellent level of the expert agreement (item-level content validity indexes = 1.00). The target items were illustrated as color pictures. Each picture was clearly drawn and easy to identify. As a pilot study of face validity, all pictures were administered to 10 typical-developing children. The actual testing was assessed by 10 CLP children, and the developed test was analyzed through consultation of the Burmese teachers and interpreters from a speech camp. Testing scores for a total including three groups of target items were shown acceptable for internal consistency reliability (ranged from 0.4 to 0.88). Conclusion The constructed test is valid in terms of its content.

Voice quality changes after functional endoscopic sinus surgery in patients with nasal polyps.

Nasal polyps are associated with hyponasality. The effect of functional endoscopic sinus surgery (FESS) on voice quality has not been adequately investigated; therefore, this study developed objective and subjective measurements to compare nasal polyp patients pre- and postsurgery. An observational prospective study was conducted at Srinagarind Hospital, Khon Kaen University, Thailand. Bilateral nasal polyposis patients who underwent FESS between August 1, 2015 and August 1, 2017, were recruited. All participants were assessed for nasal polyp grade, nasometry, acoustic parameters, acoustic perception, and patient satisfaction before surgery and at the 1-, 3- and 6-month follow-ups. Forty-six patients, 29 males and 17 females (mean age 48.2 years ± 16.2 years), were enrolled. Mean nasometry scores were significantly improved at 1, 3 and 6 months after surgery (p < 0.05), whereas the acoustic parameters were not significantly different after surgery (p > 0.05). Overall acoustic perception, assessed with a set of words and sentences, showed significant improvement in hyponasality voice after surgery (p < 0.05), whereas GIRBAS showed no significant change after surgery in each parameter of perception (p > 0.05). Patient satisfaction with voice changes after surgery was high, with significantly increased mean scores between the 1- and 6-month follow-ups (p < 0.05). The results showed that FESS for nasal polyposis patients improved voice quality and patients' voice satisfaction ratings. Trial registration: This trial was registered at the Thai Clinical Trial Registry (TCTR20210324004).

Nasal resonance changes after endoscopic endonasal transsphenoidal skull base surgery: Analysis of voice quality.

OBJECTIVES: To study the effect of endoscopic endonasal transsphenoidal surgery on voice quality in patients with pituitary lesions. METHODS: An observational study comparing voice quality before and after surgery was conducted between September 2015 and September 2017 at Srinagarind Hospital, Khon Kaen University, Thailand. Pituitary tumor patients who underwent endoscopic endonasal transsphenoidal surgery were recruited. The nasal corridors were created with a type I (preserving both middle turbinates with a rescue flap) or type II (cutting one middle turbinate with a raised nasoseptal flap) for the binostril with four-hand technique. All patients were evaluated for nasal resonance, acoustic parameters, acoustic perception, and self-assessment of their satisfaction with postoperative voice changes with a visual analog scale (VAS). The patients were evaluated 1 day before surgery and at 1 and 3 months after surgery. RESULTS: Forty-four patients, including 19 males and 25 females with a mean age of 50.0 ± 15.6 years, were enrolled. Mean scores for nasal resonance and all acoustic parameters were not significantly changed after surgery for either nasal corridor type (p > .05). Regarding acoustic perception, word and sentence and GIRBAS scores showed no significant difference before and after surgery (p > .09) in either type of nasal corridor. There was no incidence of hypernasality voice after surgery. Patients' self-satisfaction ratings (i.e., VAS) with voice quality were high and showed no significant change 1 and 3 months postsurgery (p > .05). CONCLUSIONS: These endoscopic endonasal transsphenoidal approaches are minimally invasive skull base surgery techniques that have minimal effects on postsurgery voice quality. TRIAL REGISTRATION: This trial was registered at ClinicalTrial.gov (NCT02828514). LEVEL OF EVIDENCE: 4.

Speech therapy model for patients with cleft palate in Lao People's Democratic Republic: Lack of speech services.

BACKGROUND: A majority of children with cleft lip and palate (CLP) have persistent speech and language problems after repair. Speech services are critically needed for these children in some developing countries where there is a lack of or no speech services. This includes the Lao People's Democratic Republic (LPDR) where accessibility to speech therapy is not an attainable medical specialty. OBJECTIVE: To establish and determine the effectiveness of speech therapy model in reduction of the number of articulation errors for children with CLP in LPDR where these services are lacking. METHODS: Speech therapy for children with CLP in LPDR by using the adapted Khon Kaen University Speech Therapy Model based on combining the principles of Community-Based Rehabilitation (CBR), Primary Health Care (PHC) and institutional medical approaches was provided for children with CLP in Bokeo, LPDR. Twelve children with CLP (3.6-16 years) were recruited for this study. Demonstration and teaching services for both speech assistants (SAs), who were local health care providers, and caregivers were performed in 3-day intensive speech camps. Three 1-day follow-up speech camps and 3 site visits were conducted by Thai speech and language pathologists (TSLPs) and their teams. SAs provided speech correction at local health care units based on TSLPs' individual monitoring and supervision. Caregivers practiced assigned exercises at home. Speech Therapy Model in LPDR was undertaken for 1 year. RESULTS: The Speech Therapy Model in LPDR was one of the effective models and significantly reduced number of articulatory errors (mean difference = 6.42; 95% confidence interval = 3.01, 9.83).

Five-year speech and language outcomes in children with cleft lip-palate.

OBJECTIVE: To investigate 5-year speech and language outcomes in children with cleft lip/palate (CLP). MATERIALS AND METHODS: Thirty-eight children aged 4-7 years and 8 months were recruited for this study. Speech abilities including articulation, resonance, voice, and intelligibility were assessed based on Thai Universal Parameters of Speech Outcomes. Language ability was assessed by the Language Screening Test. RESULTS: The findings revealed that children with clefts had speech and language delay, abnormal understandability, resonance abnormality, and voice disturbance; articulation defects that were 8.33 (1.75, 22.47), 50.00 (32.92, 67.08), 36.11 (20.82, 53.78), 30.56 (16.35, 48.11), and 94.44 (81.34, 99.32). CONCLUSIONS: Articulation errors were the most common speech and language defects in children with clefts, followed by abnormal understandability, resonance abnormality, and voice disturbance. These results should be of critical concern. Protocol reviewing and early intervention programs are needed for improved speech outcomes.

Speech Correction for Children with Cleft Lip and Palate in Community: Kantharawichai Networking.

Objective: To compare number of pre- and post-articulation errors of children with cleft lip and palate who enrolled in Khon Kaen University Community-Based Speech Therapy Model (KKUCSM): Kantharawichai Networking, Maha Sarakham Province. Material and Method: Seven children with cleft lip and palate (CLP) who lived in or near Kantharawichai, Maha Sarakham, were enrolled using purposive samplings in three phases. Phase I, II, and III recruited four, one and two children with CLP, respectively. The children were assessed for speech and language skills, including language, understand ability, accept ability, articulation, resonance, and voice by two qualified speech and language pathologists (SLPs) before and after each phase. Three to four of 30- to 45-minute speech therapy sessions with teaching on services for a speech assistant (SA) and caregivers were provided for each child by SLPs in intensive speech camp and each 1-day follow-up speech camp. Then, SA and caregivers gave speech corrections (SC) at networking health care unit, Kantharawichai Hospital, and at home. Each phase took approximately one year. Data were analyzed using comparisons of mean and standard deviation between numbers of pre- and post-articulation errors. Results: There was a statistically significant decrease in articulation errors after KKUCSM. Six of seven children with CLP (85.7%) had significant improvement in articulation. Conclusion: Kantharawichai Networking of KKUCSM was one of the effective ways for providing speech correction in children with CLP, particularly for those who have difficulties accessing speech services.

Prevalence of Oral Reading Problems in Thai Students with Cleft Palate, Grades 3-5.

Objective: To investigate prevalence of oral reading problems in Thai language skills, and types of oral reading in students with cleft palate, Grades 3-5. Material and Method: Thirty students with cleft palate, Grades 3-5 in the Northeast Thailand, were recruited. The students read the standard oral reading passages which are The Basic Education Commission of Thailand and consisted of basic words in curriculum of Thai language for students, Grades 1-3. Oral reading scores were analyzed based on the Basic Education Commission, Ministry of Education, Thailand. Results: The research findings revealed that: 1) The prevalence of oral reading problems in the students with cleft palate, Grades 3-5 was 16.66%; 2) Cluster was the most common problem in oral reading based on Thai language skills, followed by tone, silent consonant, irregular final consonant, change vowel, topic of word, inherent vowel, regular final consonant and word without final consonant; and 3) Types of oral reading problems were classified as substitution (56.99%), omission (36.92%), addition (1.79%) and distortion (1.79%). Conclusion: Students with cleft palate, Grade 3-5 were at risk of oral reading difficulty.

Caregivers' Role in Caring for Children with Cleft Lip-Palate in Mobile Speech Camp.

Background: Clefts lip and palate (CLP) are among the common orofacial congenital malformations. The treatment needs long-term multidisciplinary team approach. CLP impact both children's physical and psychological aspects as well as caregivers' burden. Children with CLP face challenges such as abnormal facial configuration, swallowing disorders, speech and language defects, hearing problems and dental abnormalities. Parents or caregivers play an important role in caring. Objective: To examine caregivers' role in caring for children with CLP who visited a mobile speech unit in Chiang Kham Hospital, Phayao, Thailand. Material and Method: This study was qualitative research. Caregivers of the children with CLP, who attended mobile speech camp at Chiang Kham Hospital, Phayao were recruited. Data were collected using Tawanchai Quality of Life, Thai Cleft Quality of Life Questionnaire for children with CLP and in-depth interviews. Data were analyzed using Leonard Method. Results: The majority (77.80 %) of the CLP children were cared by their mothers. Most caregivers of the children with CLP were depended on agriculture income. Their major concerns for caring the child with cleft lip and palate were a search for: 1) Treatment (70.40%): the most common information that caregivers needed was treatment; 2) Development stimulation (70.20%), especially speech and language therapy; and 3) General care (52.60%): prevention of infection; lower respiratory infection and otitis media, as well as providing effective oral intake and sucking and good nutrition, respectively. Conclusion: Mothers had a major role for caring the children with CLP. The most concern for caring was searching for treatment, followed by development stimulation, particularly speech services. The information was useful for treatment planning and providing counseling for new caregivers.

Effectiveness of Networking of Khon Kaen University Community-Based Speech Model: Quality of Life.

Background: After surgically correcting deformities in children with cleft lip/palate (CLP), 88% still had speech disorders, resonance disorders, voice abnormalities, and unintelligibility that affected daily life. Accessibility to speech therapy in developing countries is limited. The community-Based Speech Therapy Model is one means of improving communication and quality of life. Objective: To evaluate quality of life and reflections from children, families, and speech assistants (SAs) who participated in Networking of Khon Kaen University Community-Based, Speech Therapy Model (KKUCBSM) in Mahasarakham province. Material and Method: The model was piloted from March 2014 to February 2015. The Tawanchai Quality of Life questionnaire, General Health Questionnaire (Thai GHQ-12), and open-ended question feedback were used for collecting data June to August 2015. Demographic data were reported as percentages, means, standard deviations, and content analysis of openended questions. Results: Fourteen children with cleft lip and palate (mean age 5.5 years: 7 boys, 7 girls), 14 caregivers and 6 SAs were recruited for this study. Most caregivers were parents (9 families). Their needs were dental care followed by skills to support child development and skills to improve the children's speech (score 4.64+0.497, 4.57+0.646, 4.50+0.519, respectively). The score for psychosocial satisfaction vis-a-vis facial appearance was good (3.50+0.760), but for negative result scores, they felt significantly less happy, tired, and hopeless (4.79+0.579). The anxiety score was in the normal range. As a result of interviewing about problems and obstacles before joining, caregivers reported their greatest problems arose from difficulties traveling to join the project (costs were greater than reimbursements and time was insufficient). SAs reported being overworked. Benefits from participation in the project included: children with clefts consistently accessed speech services by SAs in community, caregivers gained good experiences for daily living support and speech correction. SAs gained experiences in speech correction under supervision of Speech and language pathologists (SLPs) that could be used to help other children with speech defects and other patients besides children with clefts. Conclusion: KKUCBSM for children with CLP was not only the effective way for solving articulation defects, but also improved quality of life in children with CLP.

Caregivers' Feedback after Enrollment in the Community-Based Speech Therapy Model.

Background: Khon Kaen University Community-Based Speech Therapy Model (KKUCSM) was conducted between 2012 and 2013 in Chiang Rai. Children with cleft lip and palate (CLP) and speech assistants (SAs) enrolled four-day intensive and five one-day follow-up speech camps that were run by speech and language pathologists (SLPs). KKUCSM focused on quantity of reduction of articulation errors. Therefore, it is necessary to find reflection sounds from children with CLP's caregivers for improving health care processes and services. Objective: To evaluate caregivers' reflection sounds after enrollment in the KKUCSM for a year. Material and Method: Data were collected by a focus group discussion and in-depth interviews among 20 mothers, 4 grandmothers, and 2 siblings. Participants were divided into two groups, i.e., caregivers who did and did not enroll in speech camps. Focus group discussions obtained 45 minutes per group. Content analysis was used for data summary. Results: Caregivers who enrolled in the KKUCSM told that their children with CLP were very happy with their peers. They had high self-esteem, self-confidence, good health, and academic achievement. Caregivers expected that their children could have independent living. On the other hand, caregivers who did not enroll in the KKUCSM felt that their children with CLP had low self-esteem and confidence to communicate with other people. The caregivers' concerns with their children involved image, family genetic, illness, psychosocial problems, relationship with other people, and articulation errors. Conclusion: KKUCSM mainly provided speech correction and indirectly supported children with CLP's quality of life (QOL) in psychosocial aspects and academic achievement. KKUCSM also relieved anxiety and improved family economic status.

Five-Year Hearing Outcomes in Children with Cleft Lip/Palate.

Objective: To investigate the hearing outcomes in children with cleft lip and palate or isolated cleft palate, aged 5 years. Material and Method: A cross-sectional descriptive study was performed for investigation of hearing outcomes in 35 children with cleft lip and palate, aged 5 years, Audiology Clinic, Srinagarind Hospital in 2011. Results: Thirty-five ears in 22 children (50%; 95% confidence interval = 35.57 to 64.43) had conductive hearing loss. The degree of hearing loss was highest in mild degree in 28 ears. The most common tympanometric type was type B (39 ears, 55.71%). Conclusion: The prevalence of hearing loss in children with cleft lip and palate at age 5 was high. Conductive hearing loss was the most common type. Therefore, audiological evaluation should be performed and followed until Eustachian tube function completely recovers.

Empowering Volunteers at Tawanchai Centre for Patients with Cleft Lip and Palate.

BACKGROUND: Cleft lip and palate (CLP) congenital anomalies have a high prevalence in the Northeast of Thailand. A care team's understand of treatment plan would help to guide the family of patients with CLP to achieve the treatment. OBJECTIVE: To examine the impact of the empowering volunteer project, established in the northeast Thailand. MATERIAL AND METHOD: The Empowering Volunteer project was conducted in 2008 under the Tawanchai Royal Granted project. The patients and family's general information, treatment, the group brainstorming, and satisfaction with the project were analysed. RESULTS: Participants were 12 children with CLP their families and five volunteers with CLP; the participating patients were predominantly females and the mean age was 12.2 years. The treatment comprised of speech training, dental hygiene care, bone graft and orthodontic treatment. Four issues were addressed including: problems in taking care of breast feeding, instructions' needs for care at birth, difficulty in access information and society impact, and needs in having a network of volunteers. CONCLUSIONS: Empowering volunteer is important for holistic care of patients with CLP which provides easy access and multiple channels for patients and their families. It should be developed as part of the self-help and family support group, the development of community based team and comprehensive CLP care program.

A Networking of Community-Based Speech Therapy: Borabue District, Maha Sarakham.

BACKGROUND: Most children with cleft lip and palate have articulation problems because of compensatory articulation disorders from velopharyngeal insufficiency. Theoretically, children should receive speech therapy from a speech and language pathologist (SLP) 1-2 sessions per week. For developing countries, particularly Thailand, most of them cannot reach standard speech services because of limitation of speech services and SLP Networking of a Community-Based Speech Model might be an appropriate way to solve this problem. OBJECTIVE: To study the effectiveness of a networking of Khon Kaen University (KKU) Community-Based Speech Model, Non Thong Tambon Health Promotion Hospital, Borabue, Maha Sarakham, in decreasing the number of articulation errors for children with CLP. MATERIAL AND METHOD: Six children with cleft lip and palate (CLP) who lived in Borabue and the surrounding district, Maha Sarakham, and had medical records in Srinagarind Hospital. They were assessed for pre- and post-articulation errors and provided speech therapy by SLP via teaching on service for speech assistant (SA). Then, children with CLP received speech correction (SC) by SA based on assignment and caregivers practiced home program for a year. RESULTS: Networking of Non Thong Tambon Health Promotion Hospital, Borabue, Maha Sarakham significantly reduce the number of post-articulation errors for 3 children with CLP. There were factors affecting the results in treatment of other children as follows: delayed speech and language development, hypernaslaity, and consistency of SC at local hospital and home. CONCLUSION: A networking of KKU Community-Based Speech Model, Non Thong Tambon Health Promotion Hospital, Borabue, and Maha Sarakham was a good way to enhance speech therapy in Thailand or other developing countries, where have limitation of speech services or lack of professionals.

Speech Correction for Children with Cleft Lip and Palate by Networking of Community-Based Care.

BACKGROUND: Prevalence of cleft lip and palate (CLP) is high in Northeast Thailand. Most children with CLP face many problems, particularly compensatory articulation disorders (CAD) beyond surgery while speech services and the number of speech and language pathologists (SLPs) are limited. OBJECTIVE: To determine the effectiveness of networking of Khon Kaen University (KKU) Community-Based Speech Therapy Model: Kosumphisai Hospital, Kosumphisai District and Maha Sarakham Hospital, Mueang District, Maha Sarakham Province for reduction of the number of articulations errors for children with CLP. MATERIAL AND METHOD: Eleven children with CLP were recruited in 3 1-year projects of KKU Community-Based Speech Therapy Model. Articulation tests were formally assessed by qualified language pathologists (SLPs) for baseline and post treatment outcomes. Teachings on services for speech assistants (SAs) were conducted by SLPs. Assigned speech correction (SC) was performed by SAs at home and at local hospitals. Caregivers also gave SC at home 3-4 days a week. RESULTS: Networking of Community-Based Speech Therapy Model signficantly reduced the number of articulation errors for children with CLP in both word and sentence levels (mean difference = 6.91, 95% confidence interval = 4.15-9.67; mean difference = 5.36, 95% confidence interval = 2.99-7.73, respectively). CONCLUSION: Networking by Kosumphisai and Maha Sarakham of KKU Community-Based Speech Therapy Model was a valid and efficient method for providing speech services for children with cleft palate and could be extended to any area in Thailand and other developing countries, where have similar contexts.

Speech Therapy for Children with Cleft Lip and Palate Using a Community-Based Speech Therapy Model with Speech Assistants.

OBJECTIVE: Evaluate the speech services using a Community-Based Speech Therapy model by trained speech assistants (SAs) on the improvement of articulation in cleft palate children. MATERIAL AND METHOD: Seventeen children with repaired cleft palates who lived in Chiang Rai and Phayao provinces were registered to the camp. They received speech therapy with a 4-day intensive camp and five follow-up camps at Chiang Rai's The Young Men's Christian Association (YMCA). Eight speech assistants (SAs) were trained to correct articulation errors with specific modeling by the speech-language pathologists (SLPs). SAs encouraged family members to stimulate their children every day with speech exercise at home. Each camp was covered with a main speech therapy and others supported by the multidisciplinary team, as well as, discussion among SLPs, SAs and the care givers for feedback or difficulties. RESULTS: Results showed a sufficient method for treating persistent speech disorders associated with cleft palate. Perceptual analyses presented significant improvement of misarticulation sounds both word and sentence levels after speech camp (mean difference = 1.5, 95% confidence interval = 0.5-2.5, p-value <0.01; mean difference = 2.5, 95% confidence interval = 1-3, p-value <0.001, respectively). CONCLUSION: The Community-Based Speech Therapy model is a valid and efficient method for providing speech therapy in cleft palate children.

Clinical outcomes of primary palatoplasty in preschool-aged cleft palate children in Srinagarind Hospital and comparison with other standard cleft centers.

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes regarding the rate of hypernasality and oronasal fistula formation in patients with cleft palate who underwvent primaly palatoplasty at our center and under our management protocol. MATERIAL AND METHOD: A Cross-sectional study of 40 consecutive non-syndromnic cleft palates with/or without cleft lips, born between February 2007 and December 2008, who underwent primaty palatoplasty at Srinagarind Hospital, Thailand. Demographic data that were recorded inclutdes: patients with cleft types, age atpalatoplasty, operating surgeons and surgical techniques. RESULTS: 40 consecutive patients. There were 23 boys and 17 girls. Three patients had associated disease; one patient had amniotic band syndrome and clubfeet, two patients had G-6-PD deficiency. Mean age at time of evaluation was 5.7 years (5.0-6.9 years). Mean age atpalatoplasty was 14.1 months (9-64 months). There were three plastic surgeons and plastic surreiy residents. The predominiant cleft lip type was Veau 3 (52.5%) followed by Veau 4 (27.5%) and Veau 1 (20%). Twvo-flap palatoplasty was used in all patients. The rate of hypernasality was 37.5% (15 out of 40 patients). Mild hypernasality was 25% and moderate hypernasality was 12.5%. Oronasalfistula occurred in 10 patients, fistula rate was 25%. Oronasal fistula closure was relformed on nine patients (90%). Two patients (5%) had residual oronasal fistula at the time of the study. There were no statistically significant differences in the cleft types, age at palatoplasty and operating surgeons in hypernality rates and oronas alfistula fomation. CONCLUSION: The rate of hypernasality and oronas alfistu laformation was comparable to resultsfirom other standard cleft.

Relationship of language development and hearing status in children with cleft lip and palate.

OBJECTIVE: To investigate the relationship of language development and hearing status in children with cleft lip and/or palate. MATERIAL AND METHOD: Data were collected from hospital records of 225 children with cleft lip and palate and cleft palate who underwent language and hearing assessment between June 2007 and September 2010 at Srinagarind Hospital, Khon Kaen University. Descriptive data of the language and hearing evaluation were presented. RESULTS: There was no significant correlation of language development and hearing status in children with cleft lip and/or palate. The predominant type of hearing loss that is found in normal and delay language development groups was bilateral conductive hearing loss. The sex and cleft types bore no correlation with language delays. CONCLUSION: The results of current research indicate language development of children with cleft lip and/orpalate does not depend on degree of hearing loss.

Audiological findings in cleft lip and palate children attending speech camp.

OBJECTIVE: To determine the audiological status in children with clef lip and palate attending at speech camp. MATERIAL AND METHOD: The present study was performed in children with cleft lip and palate attending speech camp. 14 children with cleft lip and/or palate registered in the speech camp for 4 days. All subjects had undergone otoscopic examination, hearing evaluation and speech and language assessment. RESULTS: Only 12 children performed the complete hearing evaluation. 16 of 23 ears had very slight hearing loss and most of them were found in children with unilateral cleft lip and palate. The air conduction thresholds ranged from 16.36 to 25.91 dB across the frequencies on the right ear and 10 to 23.18 dB on the left ear. The average pure tone thresholds showed a rising slope configuration of audiogram. CONCLUSION: The minimal hearing loss probably impacted on speech and language problems. Children with cleft lip and palate need early detection and intervention of hearing impairment.

Speech, language, voice, resonance and hearing disorders in patients with cleft lip and palate.

OBJECTIVE: To estimate the prevalence of speech, language, and hearing disorders in patients with cleft palate with or without cleft lip. MATERIAL AND METHOD: All data were retrieved from 384 medical records, transferred to case record forms and analyzed. RESULTS: The oronasal fistula rate was 15.25% (95% confidence interval: CI 11.49-19.02). The overall rates of delayed language development, articulation disorders, resonance disorders, voice disorders, and hearing disorders were 16.33% (95% CI = 12.65-20.69), 88.56% (84.47-92.65), 43.26% (95% CI = 36.58-49.93), 19.13% (95% CI = 14.26-24.82), and 79.49% (95% CI = 74.28-84.70), respectively. CONCLUSION: For speech and hearing, rates of abnormality were very high compared with those reported in the previous studies. Treatment protocols should receive more attention and intervention.