Bruneel Laura, Luyten Anke, Bettens Kim, D'haeseleer Evelien, Dhondt Cleo, Hodges Andrew, Galiwango George, 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), P.O. Box 46, Kisubi, Uganda.
J Commun Disord. 2017 Sep;69:1-14. doi: 10.1016/j.jcomdis.2017.06.010. Epub 2017 Jun 20.
Unrepaired clefts still regularly occur in resource-poor countries as a result of limited health-care access. The purpose of the present study was to report resonance, airflow and articulation characteristics following delayed (≥8years) primary palatal closure.
Fifteen Ugandan participants with cleft (lip and) palate (CP±L) were included as well as 15 age- and gender-matched Ugandan subjects without clefts. Palatal closure was performed at a mean age of 15;10 years using the Sommerlad technique. Speech evaluations were carried out on a single occasion postoperatively (mean age: 18;10 years). Resonance and nasal airflow were perceptually evaluated and detailed phonetic and phonological assessments were carried out. Additionally, nasalance values were determined.
Nasal emission occurred postoperatively in only 27% (4/15) of the patients, whereas resonance disorders and articulation errors were prevalent in 87% (13/15) of the patient group. Compared with the control group, a significantly higher prevalence of hypernasality and significantly higher nasalance values for all oral and oronasal speech samples were obtained in the CP±L group. Moreover, significantly smaller consonant inventories and significantly more phonetic and phonological disorders were observed.
Delayed palatal repair (≥8years) seems to be insufficient to eliminate nasal airflow errors, resonance abnormalities, and articulation disorders. In order to prevent patients' late presentation at specialized centers, the availability of high quality surgical cleft palate treatment should increase as well as people's awareness of the possibility and importance of early surgical intervention. Moreover, speech therapy following delayed palatal closure would be beneficial. Furthermore, a standardized and validated protocol for speech assessment in future studies is advocated.
由于医疗保健机会有限，资源匮乏国家仍经常出现未修复的腭裂。本研究的目的是报告延迟（≥8岁）一期腭裂修复后的共鸣、气流和发音特征。
纳入15名患有唇腭裂（CP±L）的乌干达参与者以及15名年龄和性别匹配的无腭裂乌干达受试者。采用Sommerlad技术在平均年龄15岁10个月时进行腭裂修复。术后单次进行语音评估（平均年龄：18岁10个月）。对共鸣和鼻气流进行感知评估，并进行详细的语音和音系学评估。此外，还测定了鼻化率值。
术后仅27%（4/15）的患者出现鼻漏气，而87%（13/15）的患者组存在共鸣障碍和发音错误。与对照组相比，CP±L组所有口腔和口鼻语音样本的高鼻音患病率显著更高，鼻化率值也显著更高。此外，观察到辅音清单明显更小，语音和音系学障碍明显更多。
延迟腭裂修复（≥8岁）似乎不足以消除鼻气流错误、共鸣异常和发音障碍。为了防止患者后期前往专科中心就诊，应增加高质量腭裂手术治疗的可及性，提高人们对早期手术干预可能性和重要性的认识。此外，延迟腭裂修复后进行言语治疗将是有益的。此外，提倡在未来研究中采用标准化和经过验证的言语评估方案。
