Surgical maxillary advancement and speech resonance: comparison among cleft types

Medeiros-Santana, Maria Natália Leite de; Araújo, Bruna Mara Adorno Marmontel; Fukushiro, Ana Paula; Trindade, Inge Elly Kiemle; Yamashita, Renata Paciello

doi:10.1590/2317-1782/20202019152

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Original Article • CoDAS 32 (4) • 2020 • https://doi.org/10.1590/2317-1782/20202019152 linkcopy

Surgical maxillary advancement and speech resonance: comparison among cleft types

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose This study investigated the influence of the cleft type on the appearance of hypernasality after surgical maxillary advancement (MA).

Methods Nasality was determined by measurement of nasalance (acoustic correlate of nasality) by nasometry. The study involved analysis of the nasalance scores of 17 individuals with isolated cleft palate (CP), 118 with unilateral cleft lip and palate (UCLP) and 69 with bilateral cleft lip and palate (BCLP), of both sexes, aged 18 to 28 years, after MA. Only individuals with normal nasalance scores indicating balanced resonance before MA were included in this study. Nasometry was performed 3 days before and 15 months after MA, on average. The proportion of patients who presented nasalance scores indicating hypernasality after surgery was calculated by the ANOVA test, and comparison among the different cleft types was evaluated by the chi-square test (p < 0.05).

Results No significant difference was found in the proportions of individuals with hypernasality among the cleft types.

Conclusion Nasometry showed that the appearance of hypernasality after MA in individuals with cleft palate with or without cleft lip occurred in similar proportions, regardless of the cleft type.

Keywords:
Cleft Palate; Orthognathic Surgery; Velopharyngeal Insufficiency; Speech; Speech Disorders

Cleft type	HYPERNASALITY AFTER MA
Cleft type	N (≤27%)	N (>27%)	Mean Nasalance (%)	ANOVA test
CP	14	3	21±11%
UCLP	98	20	21±12%	0.0927
BCLP	50	19	21±12%
Total	162	42	21±12%

	HYPERNASALITY AFTER MA
		Chi-square test	p-value
CP vs UCLP	18% vs 17%	0.075	0.785
CP vs BCLP	18% vs 27%	0.277	0.598
UCLP vs BCLP	17% vs 27%	2.350	0.125

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Sociedade Brasileira de Fonoaudiologia Al. Jaú, 684, 7º andar, 01420-002 São Paulo - SP Brasil, Tel./Fax 55 11 - 3873-4211 - São Paulo - SP - Brazil
E-mail: revista@codas.org.br

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[1] Caption: SD = Standard Deviation; MA = Surgical maxillary advancement; CP = isolated cleft palate; UCLP = unilateral cleft lip and palate; BCLP = bilateral cleft lip and palate; N (≤ 27%) = number of patients with nasalance scored indicating absence of hypernasality; N (> 27%) = number of patients with nasalance scored indicating hypernasality. Non-significant difference among groups – ANOVA test (p = 0.955)