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Influence of high and low intraoral pressure consonants on the speech nasality and nasalance in patients with repaired cleft palate

ABSTRACT

Introduction

In the cleft palate, the accurate diagnosis of speech disorders helps the rehabilitation process by directing the treatment of velopharyngeal dysfunction.

Purpose

To verify the influence of pressure consonants on speech nasality and nasalance, comparing high and low intraoral pressure stimuli in individuals with cleft palate.

Methods

Forty-four subjects with repaired cleft palate±lip, both genders, aged 6 to 59 years were simultaneously submitted to nasometry and audio speech sample recording. Nasalance scores were determined for speech samples with high-pressure consonants (HP) and low-pressure consonants (LP). Three experienced raters classified speech nasality in both samples (HP and LP) according to a 4-point scale (1 = absent hypernasality, 2 = mild hypernasality, 3 = moderate hypernasality, 4 = severe hypernasality).

Results

Nasalance scores±SD obtained for HP and LP samples were 31±15% and 31±12%, respectively, with no difference (p=1.0). The inter-rater agreement was higher for HP sample. The average rate of nasality between both samples showed difference (p=0.05). HP samples presented strong correlation between nasalance scores and hypernasality and LP samples presented substantial correlation.

Conclusion

The HP speech sample was shown to be more effective in identifying hypernasality, as it provided greater agreement among examiners in the perceived nasality analysis, had a strong correlation between the two methods used and allowed diagnosis of velopharyngeal disfunction in a larger number of individuals.

Cleft palate; Speech; Velopharyngeal insufficiency; Speech perception

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