The effect of maxillary advancement on articulation of alveolar consonants in cleft patients |
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| Institution: | 1. Cleft Palate and Craniofacial Center, Department of Plastic Surgery (Head of Department Erkki Tukiainen, Professor, MD, PhD), Helsinki University Hospital, P.O. Box 266, FI-00029, HUS, Finland;2. Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery (Head of Department Antti Aarnisalo, Adjunct Professor, MD, PhD), Helsinki University Hospital, P.O. Box 220, FI-00029, HUS, Finland;1. Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Oral and Maxillofacial Surgery, Toros University, Institute of Health Science, Toros, Turkey;1. Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Rd. Jiefang 88, Hangzhou 310009, PR China;2. Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Rd. Jiefang 88, Hangzhou 310009, PR China;1. Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium;2. Biomedical Physics, University of Antwerp, Antwerp, Belgium;1. The Center for Cleft Palate and Craniofacial Anomalies, Department of Otolaryngology – Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel;2. Communication Disorders Faculty, Hadassah Academic College, Jerusalem, Israel;3. Orthodontic and Craniofacial Center, Rambam Health Care Campus, and The Technion – Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel;4. Department of Otolaryngology – Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel;5. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;6. Department of Oral and Maxillofacial, Rambam Health Care Campus, and The Technion – Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel |
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| Abstract: | IntroductionMaxillary 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 methodsFifty-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.ResultsThe 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.ConclusionWhen 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/. |
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| Keywords: | Cleft palate Cleft lip and palate Maxillary advancement Articulation Osteotomy Speech |
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