Emilie Hagberg1, Stina Flodin2, Svante Granqvist2,3, Agneta Karsten4,5, Erik Neovius6,7, Anette Lohmander2,8. 1. 1 Stockholm Craniofacial Team, Department of Reconstructive Plastic Surgery and Functional Area Speech Language Pathology, Karolinska University Hospital, Stockholm, Sweden. 2. 2 Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. 3. 3 Unit of Basic Science, School of Technology and Health, KTH Royal Institute of Technology, Huddinge, Sweden. 4. 4 Stockholm Craniofacial Team, Karolinska University Hospital, Stockholm, Sweden. 5. 5 Division of Orthodontics, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden. 6. 6 Department of Reconstructive Plastic Surgery, Stockholms Craniofacial Center, Karolinska University Hospital, Stockholm, Sweden. 7. 7 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 8. 8 Functional Area Speech Language Pathology and Stockholm Craniofacial Team, Karolinska University Hospital, Stockholm, Sweden.
Abstract
OBJECTIVE: This study investigates the impact of maxillary advancement (Le Fort I osteotomy) on consonant proficiency in patients with cleft lip and palate (CLP) and explores how these patients and lay people perceive their speech 1 year post Le Fort I osteotomy. DESIGN: Retrospective group study before and after treatment. PARTICIPANTS: All patients with CLP who had undergone Le Fort I osteotomy for maxillary retrognathia between 2007 and 2010 at Karolinska University Hospital, Sweden (n = 21). Six patients were excluded due to additional malformations and missing data. Two experienced speech and language pathologists assessed consonant proficiency, and speech accuracy was determined by lay listeners from pre- and postoperative standardized audio recordings. The patients' satisfaction with speech postoperatively was collected from medical records. MAIN OUTCOME MEASURES: Percentage of oral consonants correct and acoustic analysis of /s/, lay listeners' opinion, and patients' satisfaction with speech. RESULTS: One year postoperation, 11 of the 15 patients had improved articulation, especially on the /s/-sound, without speech intervention. The mean percentage of oral consonants correct before treatment (82%) was significantly improved later (95%; P > .01). This assessment was supported by the patients' satisfaction with speech. However, lay listeners' opinion on accuracy was inconsistent. Length of maxillary advancement or change in occlusion did not correlate with change in articulation. CONCLUSION: Maxillary advancement performed to normalize occlusion and facial profile improved consonant proficiency in patients with CLP 1 year postoperation. Lay listeners' and patients' perceptions of speech need further exploration.
OBJECTIVE: This study investigates the impact of maxillary advancement (Le Fort I osteotomy) on consonant proficiency in patients with cleft lip and palate (CLP) and explores how these patients and lay people perceive their speech 1 year post Le Fort I osteotomy. DESIGN: Retrospective group study before and after treatment. PARTICIPANTS: All patients with CLP who had undergone Le Fort I osteotomy for maxillary retrognathia between 2007 and 2010 at Karolinska University Hospital, Sweden (n = 21). Six patients were excluded due to additional malformations and missing data. Two experienced speech and language pathologists assessed consonant proficiency, and speech accuracy was determined by lay listeners from pre- and postoperative standardized audio recordings. The patients' satisfaction with speech postoperatively was collected from medical records. MAIN OUTCOME MEASURES: Percentage of oral consonants correct and acoustic analysis of /s/, lay listeners' opinion, and patients' satisfaction with speech. RESULTS: One year postoperation, 11 of the 15 patients had improved articulation, especially on the /s/-sound, without speech intervention. The mean percentage of oral consonants correct before treatment (82%) was significantly improved later (95%; P > .01). This assessment was supported by the patients' satisfaction with speech. However, lay listeners' opinion on accuracy was inconsistent. Length of maxillary advancement or change in occlusion did not correlate with change in articulation. CONCLUSION: Maxillary advancement performed to normalize occlusion and facial profile improved consonant proficiency in patients with CLP 1 year postoperation. Lay listeners' and patients' perceptions of speech need further exploration.
Entities:
Keywords:
acoustics; articulation; dental occlusion; orthognathic surgery; osteotomy; speech production
Authors: Joy M K Tsang; Wilson S Yu; Jyrki Tuomainen; Debbie Sell; Kathy Y S Lee; Michael C F Tong; Valerie J Pereira Journal: Folia Phoniatr Logop Date: 2021-10-13 Impact factor: 1.391