Subscribe to RSS
Download PDF
DOI: 10.5999/aps.2012.39.3.198
Perceptual Speech Assessment after Maxillary Advancement Osteotomy in Patients with a Repaired Cleft Lip and Palate
This study was supported by research funds from Dong-A University.
Background Maxillary hypoplasia refers to a deficiency in the growth of the maxilla commonly seen in patients with a repaired cleft palate. Those who develop maxillary hypoplasia can be offered a repositioning of the maxilla to a functional and esthetic position. Velopharyngeal dysfunction is one of the important problems affecting speech after maxillary advancement surgery. The aim of this study was to investigate the impact of maxillary advancement on repaired cleft palate patients without preoperative deterioration in speech compared with non-cleft palate patients.
Methods Eighteen patients underwent Le Fort I osteotomy between 2005 and 2011. One patient was excluded due to preoperative deterioration in speech. Eight repaired cleft palate patients belonged to group A, and 9 non-cleft palate patients belonged to group B. Speech assessments were performed preoperatively and postoperatively by using a speech screening protocol that consisted of a list of single words designed by Ok-Ran Jung. Wilcoxon signed rank test was used to determine if there were significant differences between the preoperative and postoperative outcomes in each group A and B. And Mann-Whitney U test was used to determine if there were significant differences in the change of score between groups A and B.
Results No patients had any noticeable change in speech production on perceptual assessment after maxillary advancement in our study. Furthermore, there were no significant differences between groups A and B.
Conclusions Repaired cleft palate patients without preoperative velopharyngeal dysfunction would not have greater risk of deterioration of velopharyngeal function after maxillary advancement compared to non-cleft palate patients.
This article was presented at the 69th Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 11, 2011 in Seoul, Korea.
Publication History
Received: 21 December 2011
Accepted: 24 March 2012
Article published online:
01 May 2022
© 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
REFERENCES
- 1 Good PM, Mulliken JB, Padwa BL. Frequency of Le Fort I osteotomy after repaired cleft lip and palate or cleft palate. Cleft Palate Craniofac J 2007; 44: 396-401
- 2 O'Gara M, Wilson K. The effects of maxillofacial surgery on speech and velopharyngeal function. Clin Plast Surg 2007; 34: 395-402
- 3 Sell D, Ma L, James D. et al. A pilot study of the effects of transpalatal maxillary advancement on velopharyngeal closure in cleft palate patients. J Craniomaxillofac Surg 2002; 30: 349-354
- 4 Trindade IE, Yamashita RP, Suguimoto RM. et al. Effects of orthognathic surgery on speech and breathing of subjects with cleft lip and palate: acoustic and aerodynamic assessment. Cleft Palate Craniofac J 2003; 40: 54-64
- 5 Chanchareonsook N, Samman N, Whitehill TL. The effect of cranio-maxillofacial osteotomies and distraction osteogenesis on speech and velopharyngeal status: a critical review. Cleft Palate Craniofac J 2006; 43: 477-487
- 6 Phillips JH, Klaiman P, Delorey R. et al. Predictors of velopharyngeal insufficiency in cleft palate orthognathic surgery. Plast Reconstr Surg 2005; 115: 681-686
- 7 Kim SK, Kim MS, Heo J. et al. Speech evaluation based on the type of cleft palate. J Korean Cleft Palate-Craniofac Assoc 2008; 9: 72-76
- 8 Schwarz C, Gruner E. Logopaedic findings following advancement of the maxilla. J Maxillofac Surg 1976; 4: 40-55
- 9 Chua HD, Whitehill TL, Samman N. et al. Maxillary distraction versus orthognathic surgery in cleft lip and palate patients: effects on speech and velopharyngeal function. Int J Oral Maxillofac Surg 2010; 39: 633-640
- 10 McComb RW, Marrinan EM, Nuss RC. et al. Predictors of velopharyngeal insufficiency after Le Fort I maxillary advancement in patients with cleft palate. J Oral Maxillofac Surg 2011; 69: 2226-2232
- 11 Schendel SA, Oeschlaeger M, Wolford LM. et al. Velopharyngeal anatomy and maxillary advancement. J Maxillofac Surg 1979; 7: 116-124
- 12 Moll KL. 'Objective' Measures of Nasality. Cleft Palate J 1964; 35: 371-374
- 13 Kummer AW. Perceptual assessment of resonance and velopharyngeal function. Semin Speech Lang 2011; 32: 159-167
- 14 Peterson-Falzone SJ, Hardin-Jones MA, Karnell MP. Cleft palate speech. 2001. St. Louis: Mosby;
- 15 Kim JH, Bae YC, Hwang SM. et al. Simple method of speech evaluation in the Korean patient with cleft palate. J Korean Soc Plast Reconstr Surg 1999; 26: 858-865
- 16 Chanchareonsook N, Whitehill TL, Samman N. Speech outcome and velopharyngeal function in cleft palate: comparison of Le Fort I maxillary osteotomy and distraction osteogenesis: early results. Cleft Palate Craniofac J 2007; 44: 23-32