Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology and Shanghai Research, Institute of Stomatology, Shanghai, China.
J Craniofac Surg. 2021;32(2):655-659. doi: 10.1097/SCS.0000000000006994.
This study compared the speech outcomes of adult velopharyngeal insufficiency patients and adult cleft palate (ACP) patients, and explored whether there was any difference in the phonological level of these 2 types of patients.
Perceptual evaluation was used to assess speech intelligibility, hypernasality and compensatory articulation in 89 adult patients with velopharyngeal insufficiency and 35 adult patients with unrepaired cleft palate. Each group was divided into complete cleft palate and incomplete cleft palate (including submucous cleft palate). The phonological differences were compared between the 2 groups of patients and 2 types of cleft palate.
The mean speech intelligibility was 43.04% in velopharyngeal insufficiency group and 32.87% in ACP group. There was a significant difference in speech intelligibility between the 2 groups by T test, t = 2.916 (P < 0.01), speech intelligibility between 2 types of cleft palate was no significant difference. Also, there was a significant difference between the 2 groups in the constitution of hypernasality degree by Chi-Square test, x2 = 31.650 (P < 0.01), compensatory articulation were present in 74.3% ACP patients (26/35) and 47.2% velopharyngeal insufficiency patients (42/89), x2 = 7.446 (P < 0.01), there was a significant difference in incidence of compensatory articulation between the 2 groups.
Adult patients with unpaired cleft palate present an even worse speech intelligibility and hypernasality degree than velopharyngeal insufficiency patients after cleft palate repair, regardless of the cleft type. Additionally, patients in ACP group have a higher incidence of compensatory articulation than that in incomplete cleft palate group. In sequenced treatments of cleft lip and palate, evaluation and treatment of speech disorders cannot be ignored.
本研究比较了成人腭咽闭合不全患者和成人腭裂（ACP）患者的语音结果，并探讨了这两种患者在语音水平上是否存在差异。
采用感知评估法评估 89 例成人腭咽闭合不全患者和 35 例未修复腭裂患者的语音清晰度、过度鼻音和代偿性发音。将每组分为完全腭裂和不完全腭裂（包括黏膜下腭裂）。比较两组患者和两种腭裂类型之间的语音差异。
腭咽闭合不全组的平均语音清晰度为 43.04%，ACP 组为 32.87%。两组间 T 检验差异有统计学意义，t=2.916（P<0.01），两种腭裂类型的语音清晰度差异无统计学意义。此外，两组间过度鼻音程度构成比的卡方检验差异有统计学意义，x2=31.650（P<0.01），74.3%（26/35）的 ACP 患者和 47.2%（42/89）的腭咽闭合不全患者存在代偿性发音，x2=7.446（P<0.01），两组间代偿性发音的发生率差异有统计学意义。
未经腭裂修复的未配对腭裂成年患者的语音清晰度和过度鼻音程度均较腭咽闭合不全患者差，无论腭裂类型如何。此外，ACP 组患者的代偿性发音发生率高于不完全腭裂组。在唇腭裂序列治疗中，不能忽视语音障碍的评估和治疗。
