• Korean Journal of Cleft Lip And Palate
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• v.8 no.2
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• pp.95-105
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• 2005

Cleft lip and palate is a congenital deformity which needs a professional and consistent management from the birth and along with the physical growth of patients. The patients with cleft lip and palate can have general speech problems with resonance disorders, voice disorders and articulation disorders after the successful primary surgical management and the physical growth. Speech problems of Cleft lip and palate are characterized hypernasality, nasal air emission, increased nasal air flow, and aberrant speech marks which decrease intelligibility. These speech problems of cleft lip and palate can be treated with the secondary surgical procedure, the application of temporary prosthesis and the effective and well-timed speech therapy. The speech and language problems of cleft lip and palate, the general procedures and schedules of the speech assessment and therapy based on the multidisciplinary approach are introduced for the patients with cleft lip and palate, their family and the other members of the cleft palate treatment team.

• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.72-76
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• 2008

Purpose: Authors evaluated results of palatoplasty by speech analysis in bilateral, unilateral complete, and unilateral incomplete and submucous cleft palate patients. Methods: The speech outcomes were studied in 15 bilateral, 28 unilateral complete, and 46 unilateral incomplete and submucous cleft palate patients who underwent push-back palatoplasties from January 1998 to July 2004. The patients were divided into 2 groups as 3 to 6, 7 to 10-year-old and compared with 20 normal children(control groups were divided into 10 children on each side). Nasal emission test, hypernasality test, and articulation test were done by speech evaluation table which was composed of 39 different words. Results: In all speech evaluation tests, the group of bilateral cleft palate patients got the worst score. And 7 to 10-year-old groups got better score when compared to the same type cleft palate. Conclusion: Bilateral cleft palate patients have many more speech problems than other patients. In cleft palate patients, the speech problem was improved with ages, postoperatively. And the speech therapy can improve the operative outcomes.

• Speech Sciences
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• v.1
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• pp.237-259
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• 1997

Cleft Palate speech appears to have hyper/hyponasality with velopharyngeal insufficiency and articulation disorders. Previous studies on Cleft Palate speech have shown that speech tends to have lower airflow and air pressure. To examine the aerodynamic characteristics of Cleft Palate speech, Aerophone II Voice function Analyzer was used. We measured sound pressure level, airflow, air pressure and glottal power. Three Cleft Palate adults and five normal adults participated in this experiment. The test words are composed of: (1) the sustained vowel /o/ (2) /CiCi/, where C is one of three different stop consonants in Korean (3) /bimi/. Subjects were asked to produce /bimi/ five times without opening their lips. All the data was statistically tested by t-test for Cleft Palate patients before operation groups and control groups and paired t-test for Cleft Palate patients before and after operation groups. The results were as follow: (1) Cleft Palate patients generally speak with incomplete oral closure and lower oral air pressure. As a result, the SPL of Cleft Palate before operation is 3 dB lower than control groups. (2) Airflow of Cleft Palate in phonation and articulation is lower than that of control groups. However, it increased after operation. Lung volume and mean airflow in phonation are significantly increased (p<0.05). (3) Although velopharyngeal function (velar opening rate) of Cleft Palate is poor in comparison with control groups, it was recovered after operation. In this event maximum flow rate and mean airflow rate are significantly increased (p<0.05). (4) Air pressure of Cleft Palate in speech is lower than that of control groups. In general, the air pressure of Cleft Palate increased after operation. In this event air pressure of glottalized consonant is significantly increased (p<0.04). (5) Glottal Power(mean power, mean efficient and mean resistant) of Cleft Palate patients is lower than that of control groups. But mean efficient and mean resistant of Cleft Palate patients increased significantly (p<0.05) after operation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.4
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• pp.310-319
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• 2006

Submucosal type cleft palate is subdivision of the cleft palate. It is very difficult to find submucosal cleft, because when we exam submucosal type cleft palate patients, it seems to be normal. But in fact, there are abnormal union of palatal muscles of submucosal type cleft palate patients. Because of late detection, the treatment - for example, the operation or the speech therapy - for the submucosal type cleft palate patient usually becomes late. Some patients visited our hospital due to speech disorder nevertheless normal intraoral appearance. After precise intraoral examination, we found out submucosal cleft palate. We evaluated the speech before and after surgery of these patients. In this study, we want to find the objective characteristics of submucosal type cleft palate patients, comparing with the normal and the complete cleft palate patients. Experimental groups were 10 submucosal type cleft palate patients and 10 complete cleft palate patients who got the operation in our hospital. And, the controls were 10 normal person. The sentence patterns using in this study were simple 5 vowels. Using CSL program we evaluated the Formant, Bandwidth. We analized the spectral characteristics of speech signals of 3 groups, before and after the operation. In most cases, the formant scores were higher in experimental groups (complete cleft palate group and submucosal type cleft palate group) than controls. There were small differences when speeching /a/, /i/, /e/ between experimental groups and control groups, large differences when speeching /o/, /u/. After surgery the formant scores were decreased in experimental groups (complete cleft palate group and submucosal type cleft palate group). In bandwidth scores, there were no significant differences between experimental groups and controls.

• Korean Journal of Cleft Lip And Palate
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• v.11 no.1
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• pp.1-12
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• 2008

In cleft palate patient, characteristic of speech disorder is the resonance disorder result from velopharyngeal incompetence. Clinically VPI caused by congenital factor as congenital palatal incompetence, submucosal cleft palate, and caused by acquired factor as CNS damage, tumor, palatal palsy. The clinicians more concerned about the speech disorders after cleft palate surgery rather than language pathologist. The resonance disorder devided for hypernasality, hyponasality and nasal emission, but as a rule, hypernasality is typical phenomenon of the resonance disorder. Traditionally clinicians and language pathologists evaluated four-stage or five-stage of hypernasality by subjective assessment. Although language pathologist is well-trained, results of the language level should be different. In late 1980s, Kay Elemetrics Corp. developed nasometer that objective nasalance identified with well-trained language pathologist and originate from nasometer Tonar I and II were developed by Fletcher. Therefore objective nasalance test was possible, the nasometer used in hospital, collage and speech clinic both and home and abroad. Standardization of the cleft palate speech assessment must be settled without delay because of different character result in different language and different assessment results by dialect in same language. In our study, we provide the data base for the standardization of cleft palate speech assessment which through report of objective assessment method, speech therapy effects and problems result in interdisciplinary teamwork by nasometer use in treatment of cleft palate patient.

• Korean Journal of Cleft Lip And Palate
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• v.5 no.1
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• pp.1-9
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• 2002

Some children with Cleft Palate have shown a speech disorders after repaired surgical operation. A diagnostic evaluation of speech in children with cleft palates is important in preventing speech disorders. However, standard speech evaluation form for children with cleft palates has not yet developed in Korea. The purpose of this study is to make the standard speech evaluation form for children with cleft palates. Thirty control children group and ten children with cleft palate participated in this experiment. The test words are composed of meaningless two syllabic words containing the three different types of korean stop consonants,

• Phonetics and Speech Sciences
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• v.6 no.2
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• pp.65-71
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• 2014

The purpose of this study was to investigate whether young children with cleft palate differ from those of noncleft typically developing children in terms of expressive vocabulary size, phonological characteristics and lexical selectivity. A total of 12 children with cleft palate and 12 noncleft children who were matched by age and gender participated in the study. The groups were compared by size of expressive vocabulary reported on Korean version of MacArthur-Bates Communicative Development Inventories and the number of different words, consonant inventory, the percentage of words beginning with obstruents and vowels, nasal, and glottal sounds, and the percentage of words which do not include obstruents in a language sample. Also, correlation analysis were performed to examine the relationship between measures on size of expressive vocabulary and phonological characteristics. The results showed that expressive vocabulary size and consonant inventory for children with cleft palate produced significantly smaller than those for noncleft children. Children with cleft palate produced significantly more words beginning with vowel or which do not include obstruents, and fewer words beginning with obstruents than noncleft children. The two groups showed different results on significant correlations between measures on size of expressive vocabulary and phonological characteristics indicating that children with cleft palate show different lexical selectivity from their noncleft peers. The results suggest that children with cleft palate aged 18-30 months demonstrate a slower rate of lexical and phonological development compared with their noncleft peers and they develop lexical selectivity reflecting cleft palate speech. The results will have a clinical implication on speech-language intervention for young children with cleft palates.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.2
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• pp.53-62
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• 2005

Submucosal type cleft palate is a kind of cleft palate. A submucosal cleft may result in shortening of the anteroposterior dimension of the hard or soft palates or both. The increased distance along with the lack of muscle connection in the soft palate usually accounts for the lack of palatopharyngeal function in patients with submucosal cleft. Resonance disorders which is found in cleft patients show hypernasality or hyponasality. Many cases of submucosal type cleft palate patients visit our clinics due to hypernasality. In this study, resonance disorders was evaluated through nasalance test. Experimental group was composed of submucosal type cleft palate patients. The patients were treated by a so-called combined therapy, i.e., operation and speech training. To observe the changing pattern by surgery, nasalance test was carried out one time before surgery and three times after surgery. Nasometer II was used as a examination. The questionaire was filled with single vowels & diphthongs. The mean nasalance score of the child was significantly lower than that of the adult at every vowel. An early age at operation (under 10 years) was that a better functional result was achieved with patients. The mean nasalance score of /i/ was highest and that of /a/ was the lowest. The result of corrective surgery in selected cases has achieved improvement in all cases. Hypernasality has been consistently diminished. he operation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.1_2
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• pp.1-21
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• 1992

In order to find the causes of velopharyngeal incompetency after primary palatorrhaphy in cleft patients, we analyzed the form and function of the velopharyngeal space of fifteen operated cleft palate patients and five normal subjects. The velopharyngeal function was evaluated by lateral cephalometric radiography, velopharyngography and hypernasality cul-de-sac test. The obtained results were as follows. 1. The rate of velopharyngeal incompetency was twenty percent, three of the fifteen operated patients. Two of them were complete cleft palate and the other was incomplete one. 2. The length of soft palate and levator eminence were longer in normal group than those of good speech group and complete cleft palate group during phonation of /i/ (P<0.05). The lengthening rate of soft palate was smaller in good and poor speech group than that of normal group(P<0.05), and, reduced in order, normal group, complete cleft palate group and incomplete palate group(P<0.05). 3. The nasopharyngeal distance had no significant difference between all groups at rest, but, smaller in normal group than that of both cleft palate group(P<0.05), good speech group and poor speech group(P<0.05) during phonation of /i/ The difference in nasopharyngeal distance between rest and /i/ phonation was greater in normal group than that of both cleft palate group, good speech group and poor speech group. 4. The moving distance of sop palate reduced in order, normal group, incomplete cleft palate group, complete cleft palate group(P<0.05). 5. The distance between lateral pharyngeal wall had no significant difference between all groups in rest, but, smaller than that of complete cleft palate group in normal group(P<0.01) and increased in order normal group, good speech group, poor speech group(P<0.01) during phonation of /a/. The mobility of lateral wall was reduced in order, normal group, good speech group poor speech group(P<0. 01). 6. There was low corelationship between the mobility of lateral pharyngeal wall and soft palate. Therfore, it suggest that the movements of lateral pharyngeal wall and soft palate occurs independently.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.9.1-9.5
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• 2017

Background: Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. Methods: Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this experimentation. Instead of Korean control, the standard value of Korean version of the simplified nasometric assessment procedures (kSNAP) was used. Result: The results are as follows: (1) the highest nasalance score among the Vietnamese normal vowels is the low vowel /a/; however, that of Korean normal vowels is the high vowel /i/. (2) The average nasalance score of Korean cleft palate vowels is 18% higher than that of Vietnamese cleft palate vowels. There was a nasalance score of over 45% among the vowels /e/ and /i/ in Vietnamese cleft palate patients and /i/, /o/, and /u/ in Korean cleft palate patients. Conclusion: These different nasalance scores of the same vowels seem to cause an ethnic difference between Vietnamese and Korean cleft palate children.