Jung Seung Eun, Ha Seunghee, Koh Kyung S, Oh Tae Suk
Division of Speech Pathology and Audiology, Audiology and Speech Pathology Research Institute, Hallym University, Chuncheon, Korea.
Department of Plastic Surgery, Asan Medical Center, Seoul, Korea.
Arch Plast Surg. 2020 Nov;47(6):542-550. doi: 10.5999/aps.2020.00612. Epub 2020 Nov 15.
This study aimed to identify the initial diagnostic characteristics and treatment status of children with submucous cleft palate (SMCP) and to examine the relationship between the timing of surgical correction and the degree of articulation and resonance improvement.
This retrospective study included 72 children diagnosed with SMCP between 2008 and 2016. The evaluation criteria were the age of the initial visit, total number of visits, age at the end of treatment, speech problems, resonance problems, and speech therapy.
Children with SMCP first visited the hospital at an average age of 34.32 months, and speech problems were identified at an average age of 48.53 months. Out of 72 children, 46 underwent surgery at an average age of 49.74 months. Four of these children required secondary surgery at an average age of 83.5 months. Among the children who underwent surgery before 3 years of age, 70% exhibited articulation improvements, with mild-to-moderate hypernasality. Articulation improvements showed no statistically significant differences according to age at the time of surgery. However, children who underwent surgery before 4 years had a better hypernasality rating than those who underwent surgery after 4 years of age.
Children with SMCP tend to undergo delayed treatment because the anatomical symptoms in some children with SMCP are unclear, and surgical interventions are considered only after speech problems are clarified. Starting interventions as early as possible reduces the likelihood of receiving secondary surgery and speech therapy, while increasing expectations for positive speech function at the end.
本研究旨在确定腭裂患儿的初步诊断特征和治疗状况,并探讨手术矫正时机与发音及共鸣改善程度之间的关系。
这项回顾性研究纳入了2008年至2016年间诊断为腭裂的72名儿童。评估标准包括初诊年龄、就诊总次数、治疗结束时的年龄、言语问题、共鸣问题和言语治疗情况。
腭裂患儿首次就诊的平均年龄为34.32个月,言语问题确诊的平均年龄为48.53个月。72名儿童中,46名平均在49.74个月时接受了手术。其中4名儿童平均在83.5个月时需要二次手术。在3岁前接受手术的儿童中,70%的发音有改善,伴有轻度至中度高鼻音。根据手术时的年龄,发音改善情况无统计学显著差异。然而,4岁前接受手术的儿童高鼻音评分优于4岁后接受手术的儿童。
腭裂患儿往往治疗延迟,因为部分腭裂患儿的解剖症状不明显,只有在明确言语问题后才考虑手术干预。尽早开始干预可降低接受二次手术和言语治疗的可能性,同时提高最终获得积极言语功能的期望。