Unilateral Cleft Lip and Palate [Elektronisk resurs] Speech, Voice and Nasal Function in Adults
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Morén, Staffan (författare)
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Mani, Maria (preses)
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Holmström, Mats (preses)
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Lindestad, Per-åke (preses)
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Laurell, Göran (preses)
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Becker, Magnus (opponent)
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Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet (utgivare)
- Uppsala Acta Universitatis Upsaliensis 2018
- Engelska 89
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Serie: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1651-6206
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Sammanfattning
Ämnesord
Stäng
- Cleft lip and palate (CLP) is the most common craniofacial malformation. Even after repair of the cleft there may be persistent symptoms affecting speech, voice, nasal breathing, dentition, appearance and quality of life. The aims of the thesis were to: (I) investigate subjective nasal function and nasal airway at clinical examination, (II) evaluate speech by perceptual evaluation, (III) assess voice quality by perceptual evaluation and acoustic analysis and (IV) compare ratings of speech by naïve listeners, speech-language pathologists (SLPs) and patients. All consecutive patients with complete unilateral CLP, born 1960-1987, and treated at Uppsala University Hospital were invited. A total of 83 (76%) (I) and 73 (67%) (II, III, IV) of the 109 eligible patients and non-cleft controls (n=63) participated. Patients had been treated in childhood with one- or two-stage palate closure. The participants underwent clinical examination, recording of speech and filled in questionnaires. The results showed that: (I) Patients earlier treated for UCLP suffer from more nasal symptoms than controls. However, nasal symptoms were not associated with clinical findings or method of palate closure. (II) Seven patients (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one had reduced intelligibility. Controls had no quantifiable problems with speech. (III) Among patients, the mean values for the 12 perceptual voice variables on a visual analogue scale (0 = no abnormality, 100 = maximal abnormality) ranged between 1 and 22 and the mean for all was 6 mm. Voice variables were similar between patients and controls except “vocal fry”; this and total mean of all the perceptual voice variables were slightly lower among patients (p = 0.009 and p = 0.018 ). No clear association was found between velopharyngeal insufficiency and dysphonia. (IV). There were positive correlations between speech ratings by naïve listeners and SLPs (r =0.44 to 0.69, p always < 0.001, Spearman). The correlations between ratings of any of these groups and the patients’ self-ratings were weaker (r < 0.40). The patients were less satisfied with their speech and rated themselves to have more speech abnormalities than controls (p < 0.001). There were no statistically significant differences in any of the variables regarding speech, voice or nose between patients treated with one-stage and two-stage palate closure in any of the studies. This thesis shows that adults treated for unilateral CLP have more nasal symptoms and cleft related speech abnormalities compared to the controls, however the prevalence of speech abnormalities are relatively low. Voice quality is not affected. Speech quality is rated differently by naïve listeners, SLPs and patients.
Ämnesord
- Medical and Health Sciences (hsv)
- Clinical Medicine (hsv)
- Otorhinolaryngology (hsv)
- Medicin och hälsovetenskap (hsv)
- Klinisk medicin (hsv)
- Oto-rino-laryngologi (hsv)
- Oto-Rhino-Laryngology (uu)
- Oto-rhino-laryngologi (uu)
Indexterm och SAB-rubrik
- Adult
- Cleft Lip
- Cleft Palate
- Cross-Sectional Studies
- Control Groups
- Dysphonia
- Follow-Up Studies
- Humans
- Nasal Obstruction
- Nose Deformities
- Otolaryngology
- Quality of Life
- Reconstructive Surgical Procedures/methods
- Retrospective Studies
- Treatment Outcome
- Voice Quality
- Acoustic
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