Analysis of the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair

2013 ◽  
Vol 116 (6) ◽  
pp. e424-e428 ◽  
Author(s):  
Qi Chen ◽  
Yang Li ◽  
Bing Shi ◽  
Heng Yin ◽  
Guang-Ning Zheng ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Primary Repair ◽  
Velopharyngeal Closure

Primary Repair in Adult Patients with Untreated Cleft Lip–Cleft Palate

2007 ◽  
Vol 120 (7) ◽  
pp. 1981-1988 ◽  
Author(s):  
Daichi Morioka ◽  
Shinya Yoshimoto ◽  
Akikazu Udagawa ◽  
Fumio Ohkubo ◽  
Astushige Yoshikawa
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Primary Repair ◽  
Adult Patients

Change in Levator Veli Palatini Muscle Activity for Patients with Cleft Palate in Association with Placement of a Speech-Aid Prosthesis

2002 ◽  
Vol 39 (5) ◽  
pp. 503-508 ◽  
Author(s):  
Takashi Tachimura ◽  
Kanji Nohara ◽  
Yoshinori Fujita ◽  
Takeshi Wada
Keyword(s):  
Cleft Palate ◽  
Pressure Change ◽  
Mean Value ◽  
Emg Activity ◽  
Reserve Capacity ◽  
Activity Levels ◽  
Levator Veli Palatini ◽  
Velopharyngeal Incompetence ◽  
Velopharyngeal Closure ◽  
The Mean

Objective: The purpose of this study was to examine whether a speech-aid prosthesis normalizes the activity of the levator veli palatini muscle for patients with cleft palate who exhibit velopharyngeal incompetence. Design: Each subject was instructed to produce repetitions of /mu/, /u/, /pu/, /su/, and /tsu/ and to blow with maximum possible effort. Electromyographic (EMG) activity of the levator veli palatini muscle was recorded with and without a hybrid speech-aid prosthesis in place. Participants: The participants were five patients with repaired cleft palate who were routinely wearing a hybrid speech-aid prosthesis. Results: With the prosthesis in place, the mean value of levator activity changed positively in relation to oral air-pressure change during blowing. Differences in levator activity in relation to speech samples were similar to those in normal speakers. With the prosthesis in place, levator activity for speech tasks was less than 50% of the maximum levator activity for all subjects. The findings were similar to those reported previously for normal speakers. Conclusion: Placement of the prosthesis changed EMG activity levels of the levator veli palatini muscle to levels that are similar to normal speakers. It is possible that, with the increase in the differential levator activity between speech and a maximum force task, the velopharyngeal mechanism has a greater reserve capacity to maintain velopharyngeal closure compared with the noprosthesis condition.

Induced Velopharyngeal Fatigue Effects in Speakers with Repaired Palatal Clefts

2007 ◽  
Vol 44 (3) ◽  
pp. 251-260 ◽  
Author(s):  
Jerald B. Moon ◽  
David P. Kuehn ◽  
Grace Chan ◽  
Lili Zhao
Keyword(s):  
Cleft Palate ◽  
Muscle Activity ◽  
Regression Line ◽  
Pressure Load ◽  
Nasal Side ◽  
Velopharyngeal Closure ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Nasal Pressure ◽  
Force Data

Objective: To address whether speakers with cleft palate exhibit velopharyngeal mechanism fatigue and are more susceptible to muscle fatigue than are speakers without cleft palate. Methods: Six adults with repaired palatal clefts and mild-moderate hypernasality served as subjects. Velopharyngeal closure force and levator veli palatini muscle activity were recorded. Subjects were asked to repeat /si/ 100 times while an external load consisting of air pressure (0, 5, 15, 25, 35 cm H2O) was applied via a mask to the nasal side of the velopharyngeal mechanism. Fatigue was defined as a reduction in velopharyngeal closure force across the series of /si/ productions, as evidenced by a negatively sloped regression line fit to the closure force data. Results: Absolute levels of velopharyngeal closure force were much lower than those observed previously in speakers without palatal clefts. All subjects showed evidence of fatigue. Furthermore, all subjects demonstrated exhaustion, where they were unable to close the velopharyngeal port against the nasal pressure load. This occurred at pressure load levels lower than those successfully completed by speakers without cleft palate. Conclusions: In speakers with a repaired palatal cleft, the velopharyngeal closure muscles may not possess the same strength and/or endurance as in normal speakers. Alternatively, muscles may possess adequate strength, but not be positioned optimally within the velopharynx following cleft palate repair or may be forced to move velopharyngeal structures that are stiffer as a result of surgical scarring.

Presurgical Nasal Molding With a Nasal Spring in Patients With Mild-to-Moderate Nasal Deformity With Incomplete Unilateral Cleft Lip With or Without Cleft Palate

2018 ◽  
Vol 56 (2) ◽  
pp. 280-284
Author(s):  
Supakit Peanchitlertkajorn
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Primary Repair ◽  
Alar Cartilage ◽  
Nasal Deformity ◽  
Steep Learning Curve ◽  
Oral Plate ◽  
Cleft Nasal Deformity ◽  
Nasoalveolar Molding ◽  
Design Construction

Objective: Traditional nasoalveolar molding (NAM) requires steep learning curve for clinicians and significant compliance from parents. Nasal springs have been developed by the author to simplify presurgical nasal molding. This article presents the design, construction, and application of the spring. The treatment goal is to improve nasal deformity prior to primary repair in infants born with incomplete unilateral cleft lip with or without cleft palate. Method: The design, fabrication, and utility of the nasal spring are described. The spring has a simpler design and construction compared to a traditional NAM appliance. Participants: Two patients with incomplete unilateral cleft lip with and without cleft palate are presented. Interventions: The spring is constructed and delivered. The active arm of the spring can be 3-dimensionally (3-D) adjusted to mold the alar cartilage of the affected nostril. The spring does not require an oral plate for adherence as a traditional NAM appliance does, hence an oral impression is not needed. The spring is easy for clinicians to adjust. It also requires less compliance by parents. Main Outcome Measures/Results: The presurgical molding achieved by the use of a nasal spring improved surgical nasolabial aesthetic outcomes. Conclusion: The nasal springs are effective in reducing the initial cleft nasal deformity. This facilitates primary surgical cleft lip and nose correction and improves surgical outcomes in patients with incomplete unilateral cleft lip with or without cleft palate.

Electropalatography Treatment in an Adult with Late Repair of Cleft Palate

1996 ◽  
Vol 33 (2) ◽  
pp. 160-168 ◽  
Author(s):  
Tara L. Whitehill ◽  
Stephanie F. Stokes ◽  
Man Yuk Han Yonnie
Keyword(s):  
Cleft Palate ◽  
Treatment Efficacy ◽  
Primary Repair ◽  
Speech Disorder ◽  
Multiple Baseline ◽  
Rapid Improvement ◽  
Manner Of Articulation ◽  
The Relationship ◽  
Nasal Emission ◽  
Baseline Approach

This paper describes the use of electropalatography (EPG) in the treatment of a speech disorder in a Cantonese-speaking woman who had primary repair of the palate at age 13. A multiple-baseline approach was used to document treatment efficacy using electropalatography. The client showed rapid improvement in articulatory placement, with generalization to nontarget phonemes. In addition, improvement was noted in her manner of articulation, with a reduction of nasal emission. The relationship between articulatory placement errors and nasal emission in late repair cleft is discussed. Explanations for the effectiveness of EPG with this client are offered.

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