Luyten Anke, Bettens Kim, D'haeseleer Evelien, De Ley Sophia, Hodges Andrew, Galiwango George, Bonte Katrien, Vermeersch Hubert, Van Lierde Kristiane
Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium.
Comprehensive Rehabilitation Services in Uganda (CoRSU), PO Box 46, Kisubi, Uganda.
Int J Pediatr Otorhinolaryngol. 2014 May;78(5):787-98. doi: 10.1016/j.ijporl.2014.02.012. Epub 2014 Feb 15.
Optimal timing of palatal repair is still subject of discussion. Although literature provides some evidence that palatal closure prior to 6 months positively influence speech outcome in children with clefts, only few studies verified this hypothesis. The purpose of this study was to describe and compare articulation and resonance characteristics following early (≤6 months) and later (>6 months) palatal repair, performed using the Sommerlad technique.
Comparison was made between 12 Ugandan children with isolated cleft (lip and) palate following early palatal repair (mean age: 3.3 m) and 12 Belgian patients with later palatal repair (mean age: 11.1 m), matched for cleft type, age and gender. A Ugandan and Belgian age- and gender-matched control group without clefts was included to control for language, culture and other environmental factors. Articulation assessments consisted of consonant inventories and phonetic and phonological analyses that were based on consensus transcriptions. In addition, resonance was evaluated by perceptual consensus ratings and objective mean nasalance values.
The Belgian and Ugandan control groups were comparable for the majority of the variables. Comparison of cleft palate groups revealed no clinically relevant significant group differences for consonant inventory or phonological processes. Phonetic analysis showed significantly more distortions in the Belgian cleft palate group due to higher occurrence frequencies for (inter)dental productions of apico-alveolar consonants. Neither perceptual consensus ratings of hypernasality, hyponasality, cul-de-sac resonance and nasal emission/turbulence, nor objective mean nasalance values for oral speech samples revealed significant group differences (p>0.05).
Articulation and resonance characteristics of young children following palatal repair before and after 6 months of age seem to be at least comparable.
腭裂修复的最佳时机仍是一个讨论的话题。尽管文献提供了一些证据表明6个月前进行腭裂闭合对腭裂患儿的语音结果有积极影响，但只有少数研究证实了这一假设。本研究的目的是描述和比较采用Sommerlad技术进行早期（≤6个月）和晚期（>6个月）腭裂修复后的发音和共鸣特征。
对12例早期腭裂修复（平均年龄：3.3个月）的乌干达单纯唇腭裂患儿和12例晚期腭裂修复（平均年龄：11.1个月）的比利时患者进行比较，两组在腭裂类型、年龄和性别方面相匹配。纳入乌干达和比利时年龄及性别匹配的非腭裂对照组，以控制语言、文化和其他环境因素。发音评估包括辅音清单以及基于一致性转录的语音和音系分析。此外，通过感知一致性评分和客观平均鼻音值评估共鸣情况。
比利时和乌干达对照组在大多数变量上具有可比性。腭裂组之间的比较显示，在辅音清单或音系过程方面，没有临床相关的显著组间差异。语音分析显示，比利时腭裂组的发音扭曲明显更多，原因是舌尖齿龈辅音的齿间发音出现频率更高。无论是对高鼻音、低鼻音、盲端共鸣和鼻漏气/鼻湍流的感知一致性评分，还是口语样本的客观平均鼻音值，均未显示出显著的组间差异（p>0.05）。
6个月前后进行腭裂修复的幼儿的发音和共鸣特征似乎至少具有可比性。
