Role of Visual Feedback Treatment for Defective /s/ Sounds in Patients With Cleft Palate

1993 ◽  
Vol 36 (2) ◽  
pp. 277-285 ◽  
Author(s):  
Ken-ichi Michi ◽  
Yukari Yamashita ◽  
Satoko Imai ◽  
Noriko Suzuki ◽  
Hiroshi Yoshida
Keyword(s):  
Cleft Palate ◽  
Visual Feedback ◽  
Sound Production ◽  
Speech Training ◽  
Velopharyngeal Function ◽  
Posterior Tongue

The role of visual feedback in the treatment of defective /s/ sounds in patients with cleft palate is described. Six patients with cleft palate who were similar in age, velopharyngeal function, and type of misarticulation were selected for this study. Treatment was provided using either visual feedback or no visual feedback. Visual feedback for tongue placement was provided by the Rion Electropalatograph (EPG). Visual feedback for frication was provided by a multi-function speech training aid (MFSTA). Improvement in /s/ sound production was assessed objectively using a method described previously (Michi et al., 1986). The results indicated that visual feedback for tongue placement and frication was especially useful in the treatment of defective /s/ sounds in patients with cleft palate who exhibited abnormal posterior tongue posturing during the production of dental or alveolar sounds.

Structure of the Musculus Uvulae: Functional and Surgical Implications of an Anatomic Study

1997 ◽  
Vol 34 (6) ◽  
pp. 466-474 ◽  
Author(s):  
Martin H. S. Huang ◽  
S. T. Lee ◽  
K. Rajendran
Keyword(s):  
Cleft Palate ◽  
Posterior Pharyngeal Wall ◽  
Anatomic Study ◽  
Pharyngeal Wall ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Velopharyngeal Function ◽  
Intravelar Veloplasty ◽  
Anatomic Information

Objective: The role of the musculus uvulae in velopharyngeal function, its morphologic status in cleft palate, and its fate in palatoplasty procedures are subjects of controversy. The aims of this investigation were to re-examine this velar muscle to clarify its anatomic characteristics, to analyze its role in speech physiology, and to study the surgical implications of this information for cleft palate repair. Methods: Its attachments, morphology, and relations were examined in 18 fresh human adult cadavers by detailed dissection under 3.2× magnification and light microscopy. Results: The musculus uvulae was observed to be a paired midline muscle extending between the tensor aponeurosis anteriorly and the base of the uvula posteriorly along the nasal aspect of the velum. It had no attachments to the hard palate. Conclusions: These findings suggest that its action is to increase midline bulk on the nasal aspect of the velum, thus contributing to the levator eminence. It may also have an extensor effect on the nasal aspect of the velum, displacing it toward the posterior pharyngeal wall. Both of these actions would serve to maximize midline velopharyngeal contact. One clinical application of this anatomic information is that the muscle should be preserved in the dissection performed during intravelar veloplasty. Furthermore, it should be recognized that the musculus uvulae is invariably divided and reoriented incorrectly in the Furlow double opposing Z-plasty.

Results of a Survey of Cleft Palate Teams concerning the Use of Nasendoscopy

1993 ◽  
Vol 30 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Linda L. D'antonio ◽  
Bruce M. Achauer ◽  
Victoria M. Vander Kam
Keyword(s):  
Cleft Palate ◽  
National Survey ◽  
Standard Of Care ◽  
Research Tool ◽  
Clinical Tool ◽  
Perceptual Evaluation ◽  
Diagnostic Problems ◽  
Velopharyngeal Function ◽  
Endoscopic Assessment

A national survey was conducted concerning methods used for the evaluation of velopharyngeal function with emphasis on the role of nasendoscopy. Forty-five percent of questionnaires were returned. Ninety percent of the responding teams indicated that nasendoscopy was available. Sixty-one percent agreed that endoscopy was an important clinical tool and not solely a research tool. The majority (59%) considered 3 to 5 years of age to be the youngest, appropriate age for referral. Ninety percent agreed that nasendoscopy was indicated for difficult diagnostic problems and 41% reported endoscopic studies were appropriate for all patients for whom secondary palatal management is planned. The results of this survey suggest that endoscopic assessment of velopharyngeal function is used routinely as an adjunct to the perceptual evaluation of speech and has become the standard of care among cleft palate teams for difficult diagnostic cases. However, the data also indicate that increased availability does not necessarily assure optimal use.

The Basics of Velopharyngeal Function: A Brief Review for the Practicing Clinician

2012 ◽  
Vol 22 (2) ◽  
pp. 25-35 ◽  
Author(s):  
David L. Jones
Keyword(s):  
Cleft Palate ◽  
Gross Anatomy ◽  
Normal Anatomy ◽  
Anatomy And Physiology ◽  
Key Points ◽  
Velopharyngeal Closure ◽  
Velopharyngeal Function ◽  
And Function ◽  
Abnormal Anatomy

In this article, I will provide a basic overview of the normal anatomy and physiology of velopharyngeal function. I will address topics such as the gross anatomy of the velopharyngeal mechanism, identification of the anatomy and function of the velopharyngeal musculature, and patterns of velopharyngeal closure that occur. I will also summarize the role of the velopharyngeal mechanism as it relates to aero-acoustic aspects of speech. Although the focus of this article is normal anatomy, I do include references to abnormal anatomy (e.g. cleft palate). I will include key points to an oral mechanism examination as it pertains to velopharyngeal function.

Instrumental Assessment in Cleft Palate Care

2013 ◽  
Vol 23 (2) ◽  
pp. 49-61 ◽  
Author(s):  
Jamie Perry ◽  
Graham Schenck
Keyword(s):  
Cleft Palate ◽  
New Developments ◽  
Perceptual Evaluation ◽  
Advantages And Disadvantages ◽  
Instrumental Assessment ◽  
Speech Language Pathologist ◽  
Hypernasal Speech ◽  
Perceptual Assessment ◽  
Velopharyngeal Function ◽  
And Function

Despite advances in surgical management, it is estimated that 20–30% of children with repaired cleft palate will continue to have hypernasal speech and require a second surgery to create normal velopharyngeal function (Bricknell, McFadden, & Curran, 2002; Härtel, Karsten, & Gundlach, 1994; McWilliams, 1990). A qualitative perceptual assessment by a speech-language pathologist is considered the most important step of the evaluation for children with resonance disorders (Peterson-Falzone, Hardin-Jones, & Karnell, 2010). Direct and indirect instrumental analyses should be used to confirm or validate the perceptual evaluation of an experienced speech-language pathologist (Paal, Reulbach, Strobel-Schwarthoff, Nkenke, & Schuster, 2005). The purpose of this article is to provide an overview of current instrumental assessment methods used in cleft palate care. Both direct and indirect instrumental procedures will be reviewed with descriptions of the advantages and disadvantages of each. Lastly, new developments for evaluating velopharyngeal structures and function will be provided.

scholarly journals Adenoidectomy for middle ear disease in cleft palate children: a systematic review

2021 ◽  
Author(s):  
Cecilia Rosso ◽  
Antonio Mario Bulfamante ◽  
Carlotta Pipolo ◽  
Emanuela Fuccillo ◽  
Alberto Maccari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Case Series ◽  
Velopharyngeal Insufficiency ◽  
Middle Ear Disease ◽  
Conductive Hearing

Abstract Purpose Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. Results Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.

Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate

2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
English Speaking ◽  
And Gender ◽  
Early Primary ◽  
Velopharyngeal Function ◽  
Normal Speech

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.

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