Oral Surgery Postgraduate Program, Multidisciplinary Department of Medical, Surgical and Dental Specialties, Second University of Naples, Naples, Italy.
Speech therapist private pratictioner, Naples, Italy.
Eur J Paediatr Dent. 2014 Sep;15(3):293-6.
In this study, resonance and articulation disorders were examined in a group of patients surgically treated for cleft lip and palate, considering family social background, and children's ability of self monitoring their speech output while speaking.
Fifty children (32 males and 18 females) mean age 6.5 ± 1.6 years, affected by non-syndromic complete unilateral cleft of the lip and palate underwent the same surgical protocol. The speech level was evaluated using the Accordi's speech assessment protocol that focuses on intelligibility, nasality, nasal air escape, pharyngeal friction, and glottal stop. Pearson product-moment correlation analysis was used to detect significant associations between analysed parameters.
A total of 16% (8 children) of the sample had severe to moderate degree of nasality and nasal air escape, presence of pharyngeal friction and glottal stop, which obviously compromise speech intelligibility. Ten children (10%) showed a barely acceptable phonological outcome: nasality and nasal air escape were mild to moderate, but the intelligibility remained poor. Thirty-two children (64%) had normal speech. Statistical analysis revealed a significant correlation between the severity of nasal resonance and nasal air escape (p ≤ 0.05). No statistical significant correlation was found between the final intelligibility and the patient social background, neither between the final intelligibility nor the age of the patients.
The differences in speech outcome could be explained with a specific, subjective, and inborn ability, different for each child, in self-monitoring their speech output.
本研究通过对一组接受唇腭裂手术治疗的患者进行研究，考察了共振和发音障碍，同时考虑了家庭社会背景以及儿童在说话时自我监测言语输出的能力。
50 名儿童（32 名男性和 18 名女性），平均年龄 6.5±1.6 岁，患有非综合征性完全单侧唇腭裂，接受了相同的手术方案。使用 Accordi 语音评估方案评估语音水平，该方案侧重于可理解度、鼻音、鼻腔气流泄漏、咽摩擦音和声门塞音。采用皮尔逊积差相关分析检测分析参数之间的显著关联。
样本中共有 16%（8 名儿童）存在严重至中度程度的鼻音和鼻腔气流泄漏、咽摩擦音和声门塞音，明显影响言语可理解度。10 名儿童（10%）表现出可接受的语音清晰度：鼻音和鼻腔气流泄漏为轻度至中度，但可理解度仍然较差。32 名儿童（64%）具有正常的语音。统计分析显示，鼻腔共振的严重程度与鼻腔气流泄漏之间存在显著相关性（p≤0.05）。患者社会背景与最终语音清晰度之间以及患者年龄与最终语音清晰度之间均未发现统计学显著相关性。
语音结果的差异可以用每个孩子在自我监测言语输出方面的特定、主观和与生俱来的能力来解释。
