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Baghaki S, Karacetin G, Yerlikaya Oral E, Guzel Tuncer AB, Demir T, Bingol Caglayan H, Uysal O, Ozdamar Mandi O. Psychopathology in Infants, Toddlers, and Preschool Children with Nonsyndromic Clefts of the Lip and/or Palate: A Case-Control Study. J Craniofac Surg 2024:00001665-990000000-01881. [PMID: 39226428 DOI: 10.1097/scs.0000000000010559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 07/22/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVE The aim of this study is to assess psychopathology and maternal interactions in infants, toddlers, and preschool children with nonsyndromic clefts of the lip and/or palate (NSCLP) and association of psychopathology with cleft-related factors and maternal interactions. DESIGN Twenty-six children from 4 to 72 months of age with NSCLP, who were attending the Plastic, Reconstructive and Aesthetic Surgery Department were included as the case group. Fifty-two healthy children who were matched on age and sex with the case group were taken as controls. Children were assessed in aspects of psychiatric diagnosis, articulation, and development. RESULTS Speech and language disorders (SLD) ( P <0.001), disorders of affect (DA) ( P =0.005), feeding behavior disorder ( P =0.002), sleep-behavior disorder (SBD) ( P =0.038), and disordered mother-child relationship ( P <0.001) were more prevalent in children with NSCLP. Dental alignment ( P =0.024), number of operations ( P =0.006), and type of operations ( P =0.012) were associated with DA. The children in the case group, who had disordered relationship with their mothers had significantly more SLD ( P =0.036) and SBD ( P =0.039). CONCLUSIONS Children with NSCLP are at risk of developing psychopathology, especially SLD and DA. Maternal interactions and the above cleft-related factors and may be the target of interventions to prevent and treat psychiatric disorders in these children.
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Affiliation(s)
- Semih Baghaki
- Department of Plastic, Reconstructive and Aesthetic Surgery, Koc University Hospital, Istanbul, Turkey
| | - Gul Karacetin
- Department of Child and Adolescent Psychiatry, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, University of Health Sciences, Istanbul, Turkey
| | - Elif Yerlikaya Oral
- Department of Child and Adolescent Psychiatry, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, University of Health Sciences, Istanbul, Turkey
| | - Ayse Beste Guzel Tuncer
- Department of Child and Adolescent Psychiatry, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, University of Health Sciences, Istanbul, Turkey
| | - Turkay Demir
- Department of Child and Adolescent Psychiatry, Private Practice, Istanbul, Turkey
| | | | - Omer Uysal
- Department of Child and Adolescent Psychiatry, Private Practice, Istanbul, Turkey
| | - Ozlem Ozdamar Mandi
- Department of Biostatistics and Medical Informatics, Bezmialem Vakif University Medical School, Istanbul, Turkey
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Chen YH, Lee MLC, Liow SJR, Ee-Li Young S. Exploring the relationship between cleft type and speech outcome in 4-to-6-year-olds with non-syndromic cleft palate using different measures: A preliminary report. CLINICAL LINGUISTICS & PHONETICS 2024:1-16. [PMID: 38832412 DOI: 10.1080/02699206.2024.2356035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 05/10/2024] [Indexed: 06/05/2024]
Abstract
Cleft type affects speech outcomes, but exact relationships remain unclear as outcome measures vary. The primary aim was to investigate the relationship between cleft type and speech outcome using different measures in 4-to-6-year-olds with non-syndromic clefts. Secondary aims were to explore the relationships between (i) speech measures used; and (ii) parent perception of speech intelligibility and listener familiarity. Twenty-two pre-schoolers with clefts, plus one parent for each child, were recruited through a hospital outpatient clinic. Children with cleft lip and palate (CLP; n = 11) and those with cleft palate only (CP; n = 11), matched on age and time of palate repair, were compared on Percentage Consonants Correct (PCC), clinician-reported speech intelligibility, and parent rating on the Intelligibility-in-Context Scale (ICS). Children with CLP had significantly lower PCC scores than children with CP (p = .020), but had no significant differences in their clinician- or parent-reported speech intelligibility. Clinician-reported speech intelligibility correlated significantly with both PCC (τ = .594, p < 0.01) and ICS (τ = .424, p = 0.009). No significant correlation was found between PCC and ICS (τ =.197, p = 0.113). Overall, parents rated their child's intelligibility higher for familiar compared to unfamiliar communication partners (τ = 2.325, p = 0.001, r = .76). Cleft type is crucial for intervention planning when objective measures are employed. Speech outcomes should be evaluated at impairment, activity, and participation levels, and by different communication partners, to comprehensively evaluate communicative effectiveness.
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Affiliation(s)
- Yu Hui Chen
- Division of Graduate Medical Studies, National University of Singapore, Singapore, Singapore
| | - Mary Lay Choo Lee
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Susan J Rickard Liow
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Selena Ee-Li Young
- Cleft and Craniofacial Centre, Department of Plastic, Reconstructive & Aesthetic Surgery, KK Women's and Children's Hospital, Singapore, Singapore
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Hosseinabad HH, Bai X. Effects of multitasker babble noise on speech intelligibility in children with velopharyngeal insufficiency (VPI). INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:1814-1828. [PMID: 37294086 DOI: 10.1111/1460-6984.12913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 05/16/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Intelligibility measurement is influenced by the characteristics of a speaker, listener and contextual factors. This study addresses the clinical problem of measuring speech intelligibility in children with velopharyngeal insufficiency (VPI) in real-world conditions. AIMS The purpose of the study was to investigate the effects of background noise on speech intelligibility in speakers with velopharyngeal insufficiency (VPI) compared to typical speech. The study further determined the contribution of nasalance and articulation accuracy in judgments of intelligibility. METHODS & PROCEDURES Fifteen speakers diagnosed with VPI and their typical peers provided audio recordings of 20 sentences from the Hearing in Noise Test. Speech samples were presented over quiet and noise (+5 dB signal-to-noise ratio) conditions to 70 naïve listeners. Intelligibility scores from naïve listeners' orthographic transcriptions were obtained as the percentage of correctly identified words. OUTCOMES & RESULTS A repeated-measures analysis of variance showed diagnosis of VPI (F(1, 28) = 13.44, p = 0.001, and presence of noise (F(1, 28) = 39.18, p < 0.001) significantly affected the intelligibility scores. There was no interaction between the diagnosis of VPI and noise (F(1, 28) = 0.06, p = 0.80). The multivariate regression analysis indicated that nasalance and articulation accuracy explain a significant amount of variance in the intelligibility scores of VPI speakers in quiet (F(2, 12) = 7.11, p < 0.05, R2 = 0.55, R2 Adjusted = 0.47) and noise (F(2, 12) = 6.32, p < 0.05, R2 = 0.51, R2 Adjusted = 0.43), but the significance mainly came from the effect of percentage of consonants correct (β = 0.97, t(12) = 2.90, p = 0.01). Percentage of consonants correct significantly increased the speech intelligibility in either with or without noise conditions. CONCLUSIONS & IMPLICATIONS The current work suggests that background noise will significantly affect reductions in intelligibility in both groups; the effect is more prominent in VPI speech. It was also further noted that articulation accuracy significantly affected intelligibility in quiet and noise rather than nasalance scores. WHAT THIS PAPER ADDS What is already known on the subject Intelligibility measurement is influenced by the characteristics of a speaker, listener and contextual factors. Accordingly, it is essential to determine the degree to which speech assessments in the clinic can predict communication difficulties in the presence of background noise in real life. Background noise can adversely cause speech intelligibility degradation in individuals with speech disorders. What this study adds The study examined the effects of background noise on speech intelligibility in speakers with velopharyngeal insufficiency (VPI) secondary to cleft palate compared to typical speech. The study results suggested that the presence of background noise will significantly affect reductions in intelligibility in both groups; however, the effect is more prominent in VPI speech. What are the clinical implications of this work? We found out that the intelligibility of VPI speech is lower in the presence of background noise, and therefore, assessments of speech intelligibility in clinical settings should take this into account. To ensure effective communication in noisy environments, recommended strategies include selecting quiet locations, eliminating potential distractions and supplementing communication with nonverbal cues. It is important to recognize that the effectiveness of these strategies may vary depending on the individual and the specific communication context.
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Affiliation(s)
- Hedieh Hashemi Hosseinabad
- Department of Audiology and Speech Language Pathology, College of Health and Public Service, University, of North Texas, Denton, Texas, USA
| | - Xiuqin Bai
- Department of Mathematics, Eastern Washington University, Spokane, Washington, USA
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Bschorer F, Hornig L, Schön G, Bschorer R. Speech assessment following microsurgical soft palate repair. J Craniomaxillofac Surg 2023; 51:199-204. [PMID: 36878754 DOI: 10.1016/j.jcms.2023.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 11/01/2022] [Accepted: 01/22/2023] [Indexed: 01/26/2023] Open
Abstract
The aim of this study was to analyze speech intelligibility of children, who had undergone microsurgical soft palate repair according to Sommerlad. Cleft palate patients were treated by closure of the soft palate according to Sommerlad at about 6 months of age. At the age of 11, their speech was evaluated through automatic speech recognition. Word recognition rate (WR) was used as the outcome parameter of automatic speech recognition. To validate automatic speech results, an institute for speech therapy evaluated the speech samples for perceptual intelligibility. The results of this study group were compared to an age-matched control group. A total of 61 children were evaluated in this study, 29 in the study group and 32 in the control group. Study group patients had a lower word recognition rate (mean 43.03, SD 12.31) compared to the control group (mean 49.98, SD 12.54, p = 0.033). The magnitude of the difference was considered small (95% CI of the difference 0.6-13.3). The study group patients received significantly lower scores in the perceptual evaluation (mean 1.82, SD 0.58) compared to the control group mean (mean 1.51, SD 0.48, p = 0.028). Again, the magnitude of the difference was small (95% CI of the difference 0.03-0.57). Within the limitations of the study it seems that microsurgical soft palate repair according to Sommerlad at the age of 6 months might be a relevant alternative to other well established surgical techniques.
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Affiliation(s)
- Frizzi Bschorer
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany; Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Rostock University Medical Center, Schillingallee 35, 18057, Rostock, Germany.
| | - Lena Hornig
- ISBA University of Cooperative Education, Ziegelseestr. 1, 19055, Schwerin, Germany
| | - Gerhard Schön
- Department of Medical Biometry and Epidemiology, Eppendorf University Hospital, University of Hamburg, Martinistr. 52, D-20246, Hamburg, Germany
| | - Reinhard Bschorer
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany; MKG-Praxis Am Stadthafen, Schliemannstraße 18, 19055, Schwerin, Germany
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Seifert M, Davies A, Harding S, McLeod S, Wren Y. Intelligibility in 3-Year-Olds With Cleft Lip and/or Palate Using the Intelligibility in Context Scale: Findings from the Cleft Collective Cohort Study. Cleft Palate Craniofac J 2021; 58:1178-1189. [DOI: 10.1177/1055665620985747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To provide comparison data on the Intelligibility in Context Scale (ICS) for a sample of 3-year-old English-speaking children born with any cleft type. Design: Questionnaire data from the Cleft Collective Cohort Study were used. Descriptive and inferential statistics were carried out to determine difference according to children’s cleft type and syndromic status. Participants: A total of 412 children born with cleft lip and/or palate whose mothers had completed the ICS when their child was 3 years old. Main Outcome Measure(s): Mothers’ rating of their children’s intelligibility using the ICS. Results: The average ICS score for the total sample was 3.75 ( sometimes-usually intelligible; standard deviation [SD] = 0.76, 95% CIs = 3.68-3.83) of a possible score of 5 ( always intelligible). Children’s speech was reported to be most intelligible to their mothers (mean = 4.33, SD = 0.61, 95% CIs = 4.27-4.39) and least intelligible to strangers (mean = 3.36, SD = 1.00, 95% CIs = 3.26-3.45). There was strong evidence ( P < .001) for a difference in intelligibility between children with cleft lip only (n = 104, mean = 4.13, SD = 0.62, 95% CIs = 4.01-4.25) and children with any form of cleft palate (n = 308, mean = 3.63, SD = 0.76, 95% CIs = 3.52-3.71). Children born with cleft palate with or without cleft lip and an identified syndrome were rated as less intelligible (n = 63, mean = 3.28, SD = 0.85, 95% CIs = 3.06-3.49) compared to children who did not have a syndrome (n = 245, mean = 3.72, SD = 0.71, 95% CIs = 3.63-3.81). Conclusions: These results provide preliminary comparative data for clinical services using the outcome measures recommended by the International Consortium for Health Outcomes Measurement.
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Affiliation(s)
- Miriam Seifert
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, United Kingdom
| | - Amy Davies
- University of Bristol, Bristol, United Kingdom
| | - Sam Harding
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - Sharynne McLeod
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Yvonne Wren
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
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Rezaei P, Poorjavad M, Abdali H. Speech outcomes after palatal closure in 3-7-year-old children. Braz J Otorhinolaryngol 2020; 88:594-601. [PMID: 33268307 PMCID: PMC9422456 DOI: 10.1016/j.bjorl.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 08/02/2020] [Accepted: 08/22/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction One of the main goals of the team approach in management of oro-facial clefts is to help the children with cleft palate have adequate speech development. Objective The present study aimed to investigate the prevalence of articulation and resonance disorders following palate closure in children who were visited for routine examination by the Isfahan Cleft Care Team between 2011 and 2015, and to study the impact of cleft type and age at the time of palatoplasty on speech outcomes. Methods Clinical records of 180 preschool children with repaired cleft palate were reviewed. The percentage of children demonstrating hypernasality, nasal emission, nasal turbulence, and compensatory misarticulations was calculated. The relationship between cleft type and age at the time of palatal surgery, as independent variables, and speech outcomes were examined. Results 67.7 and 64.5 percent of the children demonstrated respectively moderate/severe hypernasality and nasal emission, and 71.1 percent produced compensatory misarticulations. Age at the time of palatal repair was significantly associated with compensatory misarticulations and also with moderate/severe hypernasality. The prevalence of compensatory misarticulations, significant hypernasality, nasal emission and also nasal turbulence was not significantly different in various types of cleft. Conclusions We observed a high prevalence of different speech disorders in preschool children with repaired cleft palate compared to other studies. This can be partly due to late palatal repair in the studied population. Despite many advances in cleft palate management programs in Iran, there are still many children who do not access the interdisciplinary team cares in their early childhood. We should, therefore, try to increase accessibility of appropriate and timely management services to all Iranian children with cleft lip/palate.
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Affiliation(s)
- Parisa Rezaei
- Isfahan University of Medical Sciences, Craniofacial and Cleft Research Center, Isfahan, Iran; Isfahan University of Medical Sciences, School of Rehabilitation Sciences, department of Speech Therapy, Isfahan, Iran
| | - Marziyeh Poorjavad
- Isfahan University of Medical Sciences, School of Rehabilitation Sciences, department of Speech Therapy, Isfahan, Iran.
| | - Hossein Abdali
- Isfahan University of Medical Sciences, Craniofacial and Cleft Research Center, Isfahan, Iran; Isfahan University of Medical Sciences, Department of Plastic Surgery, Isfahan, Iran
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Kalita S, Girish KS, M P, Mahadeva Prasanna SR, Dandapat S. Objective assessment of cleft lip and palate speech intelligibility using articulation and hypernasality measures. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:1164. [PMID: 31472592 DOI: 10.1121/1.5121310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 07/19/2019] [Indexed: 06/10/2023]
Abstract
Assessment of intelligibility is required to characterize the overall speech production capability and to measure the speech outcome of different interventions for individuals with cleft lip and palate (CLP). Researchers have found that articulation error and hypernasality have a significant effect on the degradation of CLP speech intelligibility. Motivated by this finding, the present work proposes an objective measure of sentence-level intelligibility by combining the information of articulation deficits and hypernasality. These two speech disorders represent different aspects of CLP speech. Hence, it is expected that the composite measure based on them may utilize complementary clinical information. The objective scores of articulation and hypernasality are used as features to train a regression model, and the output of the model is considered as the predicted intelligibility score. The Spearman's correlation coefficient based analysis shows a significant correlation between the predicted and perceptual intelligibility scores (ρ = 0.77, p < 0.001).
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Affiliation(s)
- Sishir Kalita
- Department of Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| | - K S Girish
- Department of Electronics, All India Institute of Speech and Hearing, Mysuru 570006, India
| | - Pushpavathi M
- Department of Electronics, All India Institute of Speech and Hearing, Mysuru 570006, India
| | - S R Mahadeva Prasanna
- Department of Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| | - S Dandapat
- Department of Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
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Kalita S, Mahadeva Prasanna SR, Dandapat S. Intelligibility assessment of cleft lip and palate speech using Gaussian posteriograms based on joint spectro-temporal features. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2018; 144:2413. [PMID: 30404473 DOI: 10.1121/1.5064463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/02/2018] [Indexed: 06/08/2023]
Abstract
Intelligibility is considered as one of the primary measures for speech rehabilitation of individuals with a cleft lip and palate (CLP). Currently, speech processing and machine-learning-based objective methods are gaining more research interest as a way to quantify speech intelligibility. In this work, joint spectro-temporal features computed from a time-frequency representation of speech are explored to derive speech representations based on Gaussian posteriograms. A comparative framework using dynamic time warping (DTW) is used to quantify the intelligibility of child CLP speech. The DTW distance is used to score sentence-level intelligibility and tested for correlation with perceptual intelligibility ratings obtained from expert speech-language pathologists. A baseline DTW system using the conventional Mel-frequency cepstral coefficients (MFCCs) is also developed to compare the performance of the proposed system. Spearman's rank correlation coefficient between the objective intelligibility scores and the perceptual intelligibility rating is studied. A Williams significance test is conducted to assess the statistical significance of the correlation difference between the methods. The results show that the system based on joint spectro-temporal features significantly outperforms the MFCC-based system.
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Affiliation(s)
- Sishir Kalita
- Department of Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| | - S R Mahadeva Prasanna
- Department of Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| | - S Dandapat
- Department of Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
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Menegueti KI, Mangilli LD, Alonso N, Andrade CRFD. Perfil da fala de pacientes submetidos à palatoplastia primária. Codas 2017; 29:e20160146. [DOI: 10.1590/2317-1782/20172016146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 04/30/2017] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo caracterizar o perfil e a fala de pacientes submetidos à palatoplastia primária em um hospital escola de São Paulo, levando-se em consideração a idade do paciente no momento da cirurgia (precoce até os 2 anos de idade e tardio após 2 anos). Método 97 indivíduos, de ambos os gêneros, com diagnóstico de fissura de palato associada ou não à de lábio, divididos em dois grupos: 1) grupo precoce (GP), composto por 43 indivíduos operados até o segundo ano de vida; 2) grupo tardio (GT), composto por 54 indivíduos operados após o segundo ano. Os participantes foram submetidos à avaliação clínica fonoaudiológica. Os parâmetros avaliados e considerados para o estudo foram: classificação da ressonância, presença de ronco nasal audível, ocorrência de fraca pressão intraoral, ocorrência de emissão nasal, classificação da inteligibilidade de fala e presença de distúrbios articulatórios compensatórios (DACs). Uma porcentagem randomicamente selecionada de participantes (30%) foi reavaliada por mais duas fonoaudiólogas e a comparação entre os juízes indicou alta concordância. Resultados (nível de significância de 5%): os grupos não se diferenciaram em relação à classificação da ressonância (p=0,067), grau de hipernasalidade (p=0,113), presença de ronco nasal (p=0,179), ocorrência de fraca pressão intraoral (p=0,152), ocorrência de emissão nasal (p=0,369) e classificação da inteligibilidade de fala (p=0,113). Em relação à presença de DACs, os grupos se diferenciaram (p=0,020), com maior ocorrência de fonemas alterados no GT. Conclusão foi possível caracterizar o perfil geral e de fala dos pacientes submetidos à palatoplastia primária do referido hospital escola. Concluiu-se que a realização da cirurgia precocemente traz melhores resultados em relação à fala.
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Automated cleft speech evaluation using speech recognition. J Craniomaxillofac Surg 2017; 45:1268-1271. [DOI: 10.1016/j.jcms.2017.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/04/2017] [Accepted: 05/05/2017] [Indexed: 11/17/2022] Open
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Nkenke E, Vairaktaris E, Schlittenbauer T, Eitner S. Masticatory Rehabilitation of a Patient with Cleft Lip and Palate Malformation Using a Maxillary Full-Arch Reconstruction with a Prefabricated Fibula Flap. Cleft Palate Craniofac J 2016; 53:736-740. [DOI: 10.1597/15-051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
For full-arch reconstruction of an atrophied cleft maxilla with missing premaxilla, a prefabricated microvascular free bony flap is a relevant option. A fibula flap was prefabricated in a cleft patient who received six dental implants and an epithelial layer. Six weeks later, maxillary reconstruction was performed. The inpatient period could be confined to 2 weeks. A fixed provisional prosthesis was delivered after an additional 2 weeks. A prefabricated flap allows for the reduction of the interval without a dental prosthesis to only a few weeks, even when a complex full-arch reconstruction of the maxilla is required.
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Affiliation(s)
- Emeka Nkenke
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Vienna, Austria
| | - Elefterios Vairaktaris
- Department of Oral and Maxillofacial Surgery, University of Athens Medical School, Attikon Hospital, Athens, Greece
| | - Tilo Schlittenbauer
- Department of Oral and Maxillofacial Surgery, Erlangen University Hospital, Erlangen, Germany
| | - Stephan Eitner
- Department of Prosthodontics, Erlangen University Hospital, Erlangen, Germany
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Schuster M, Stelzle F. Outcome measurements after oral cancer treatment: speech and speech-related aspects--an overview. Oral Maxillofac Surg 2012; 16:291-8. [PMID: 22864645 DOI: 10.1007/s10006-012-0340-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 07/16/2012] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Oral cancer and its surgical treatment impair speech quality by an alteration of the vocal tract. Local size and stage of the tumour as well as surgical and adjuvant treatment modalities have an impact on the functional outcome of patients' speech rehabilitation. It was the aim of this overview to specifiy speech and speech-related aspects as well as to delineate measurement methods of speech outcome in patients with oral cancer by a review of the literature. METHODS The review is based on a Medline Search on "speech", "cancer", "oral cancer", "malignoma mouth", "intelligibility", "formant", "ultrasound". DISCUSSION In particular, speech intelligibility is inevitable for the social interaction of patients which is highly correlated with the patient's quality of life. However, speech outcome measurement shows a variety of methods without an international standardisation. Additionally, several co-aspects of speech production have to be considered: tongue mobility, voice production, velopharyngeal closure and neural coordination are important influencing factors. Speech assessment is traditionally performed by perceptual methods on a subjective or semi-subjective base. More objective, technical-based methods of speech evaluation are in development and under research. PURPOSE It was the aim of this overview to specify speech and speech-related aspects as well as to delineate measurement methods of speech outcome in patients with oral cancer by a review of the current literature.
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Affiliation(s)
- M Schuster
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
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