The effect of maxillary advancement on articulation of alveolar consonants in cleft patients
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Alaluusua , S , Harjunpää , R , Turunen , L , Geneid , A , Leikola , J & Heliövaara , A 2020 , ' The effect of maxillary advancement on articulation of alveolar consonants in cleft patients ' , Journal of Cranio-Maxillo-Facial Surgery , vol. 48 , no. 5 , pp. 472-476 . https://doi.org/10.1016/j.jcms.2020.02.002
| Title: | The effect of maxillary advancement on articulation of alveolar consonants in cleft patients |
| Author: | Alaluusua, Suvi; Harjunpää, Roni; Turunen, Leena; Geneid, Ahmed; Leikola, Junnu; Heliövaara, Arja |
| Contributor organization: | HUS Musculoskeletal and Plastic Surgery Plastiikkakirurgian yksikkö Helsinki University Hospital Area HUS Head and Neck Center Korva-, nenä- ja kurkkutautien klinikka |
| Date: | 2020-02-14 |
| Language: | eng |
| Number of pages: | 5 |
| Belongs to series: | Journal of Cranio-Maxillo-Facial Surgery |
| ISSN: | 1010-5182 |
| DOI: | https://doi.org/10.1016/j.jcms.2020.02.002 |
| URI: | http://hdl.handle.net/10138/326421 |
| Abstract: | Introduction Maxillary advancement may affect speech in cleft patients. The aim of this study was to evaluate the effect of maxillary advancement on Finnish alveolar consonants/s/,/l/, and/r/in cleft patients. Materials and methods Fifty-nine Finnish-speaking nonsyndromic cleft patients, who had undergone Le Fort I or bimaxillary osteotomies, were evaluated retrospectively Production of the Finnish alveolar consonants/s/,/l/, and/r/was assessed from pre- and postoperative standardized video recordings by two experienced speech pathologists. McNemar’s test was used in the statistical analyses. Kappa statistics were calculated to assess reliability. Results The patients included 35 females and 24 males with CP (n = 12), UCLP (n = 31), and BCLP (n = 16). There was a significant improvement in/s/and/l/sounds after maxillary advancement (p = 0.039 and p = 0.002, respectively). The preoperative mean percentage of/s/errors was 34%; postoperatively it was 20%./L/was misarticulated preoperatively by 34% of the patients and postoperatively by 19%./R/was misarticulated preoperatively by 47% of the patients and postoperatively by 42%. The level of mild articulation errors rose from 25% to 31%, while severe articulation errors decreased from 37% to 25%. The reliabilities were good. Conclusion When planning orthognathic surgery in cleft patients with maxillary retrusion and articulation errors, advancement of the maxilla might be a means for improving articulation of/s/and/l/. |
| Subject: |
3126 Surgery, anesthesiology, intensive care, radiology
cleft palate cleft lip and palate maxillary advancement articulation osteotomy speech Cleft palate Osteotomy I OSTEOTOMY CRANIOFACIAL CEPHALOMETRIC MORPHOLOGY SPEECH PALATE Articulation LIP ORTHOGNATHIC SURGERY Speech LATER NEED Maxillary advancement VELOPHARYNGEAL FUNCTION Cleft lip and palate AGE |
| Peer reviewed: | Yes |
| Rights: | cc_by_nc_nd |
| Usage restriction: | openAccess |
| Self-archived version: | acceptedVersion |
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(2019)Introduction: Maxillary advancement may affect speech in cleft patients. The aim of this study was to evaluate whether preoperative velopharyngeal (VP) function and cleft type can predict VP function after a Le Fort I maxillary osteotomy. Materials and methods: One hundred consecutive nonsyndromic cleft patients (54 females, 64 males) who underwent Le Fort I osteotomies were retrospectively evaluated. Pre- and postoperative VP function was assessed perceptually and instrumentally by a Nasometer. A five-point scale was used to rate velopharyngeal insufficiency symptoms (VPI 0-4). To assess reliability, 30 video recordings were re-evaluated. Results: Preoperatively, 89% of patients had normal or insignificant VPI (0-1), and only 3% had moderate VPI (3). Postoperatively, 77% of patients had VPI values of 0-1 and 14% had moderate to severe VPI values (VPI 3-4). A positive correlation was found between pre- and postoperative VPI scores, whereas the cleft type did not affect speech results. Patients with a preoperatively normal VPI (0) were not at risk for postoperative velopharyngeal incompetence. Conclusions: There was an overall significant negative change in speech after a Le Fort I osteotomy. At-risk patients presented with borderline (1) or more severe VPI (2 and 3) preoperatively. (C) 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.