Clinical Management of Speech-Language and Speech Results after Primary Palatoplasty in Cleft Pa late Children in Osaka Medical Center & Resear c h Institute for Maternal & Child Health

• Published in: Journal of Japanese Cleft Palate Association Vol. 18; no. 3; pp. 241 - 250
• Main Authors: KAWAMOTO, Manami, SAKO, Michiyo, KITAMURA, Ryuuji, NISHIO, Juntaro, MIYAZAKI, Tadashi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Cleft Palate Association 30.07.1993
• Subjects: articulation disorder; cleft pa late child; clinical management of speech-language; speech results; velopharyngeal function; 口蓋裂児; 異常構音; 言語成績; 言語管理体制; 鼻咽腔閉鎖機能
• ISSN: 0386-5185; 2186-5701
• DOI: 10.11224/cleftpalate1976.18.3_241

This paper reports the outline of our clinical management of speech-language, and the speech results after primary palatoplasty of cleft palate children in Osaka Medical Center & Research Institute for Maternal & Child Health from 1987 to 1991. This speech-language management includes the eva luation of mental and speech-language development and the advice to the parents, and is performed regularly from 3 months-old by the speech therapist. Speech results after primary palatoplasty had been investigated in 76 cleft palate children including 12 with bilateral cleft lip and palate,35 with unilateral cleft lip and palate, and 29 with isolated cleft palate. The operation was performed by push-back method at about 16.6 months old. The speech results were obtained more than 1 year after the operation. The velopharyngeal closure was almost sufficient in 73 children (96 %). Articulation disorders were observed in 37 children (64 %), they were more than 3 years old, with sufficient velopharyngeal closure except 2 cases, having 53 errors totally. Nasopharyngeal articulation was accounted for the highest percentage of articulation disorders, but they all recovered spontaneously until age 3.5 years. Since our investigation was undertaken so ear ly in order to obtain the final judgement after operation, we should evaluate the velopharyngeal function and the articulation at an adequate period again. The speech-language management should be provided from the preoperative period reg arding the psychological problems of the parents, and should work functionally in the treatment system for patients with cleft lip and palate.