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Larynx01:21

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A thorough mouth assessment, including inspection and palpation of the lips, gums, tongue, tonsils, uvula, and pharynx, is crucial in detecting potential health issues. Diseases ranging from oral cancer to systemic conditions like diabetes could be identified early through careful oral examination. This article provides a detailed guide on conducting a comprehensive mouth assessment.
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Longitudinal Speech Changes in Velopharyngeal Function in Submucous Cleft Palate.

Soukaina Eljamri1, Randall Harley2, Matthew Ford3

  • 1University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|March 10, 2025
PubMed
Summary

Speech in children with submucous cleft palate and velopharyngeal dysfunction can improve without surgery, but surgical intervention offers faster speech development. Early surgery is crucial for optimal speech outcomes in these patients.

Keywords:
Pittsburgh Weighted Speech Scorefurlow palatoplastyspeechsubmucous cleft palatevelopharyngeal dysfunction

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Area of Science:

  • Speech Pathology
  • Craniofacial Surgery
  • Pediatric Otolaryngology

Background:

  • Submucous cleft palate (SMCP) often leads to velopharyngeal dysfunction (VPD), impacting speech clarity.
  • Understanding longitudinal speech changes is vital for managing SMCP and VPD.
  • Surgical and nonsurgical management strategies have different impacts on speech development.

Purpose of the Study:

  • To evaluate and compare longitudinal speech changes in pediatric patients with SMCP and VPD.
  • To determine the impact of surgical intervention versus non-surgical management on speech trajectories.
  • To identify the rate of speech improvement over time in both groups.

Main Methods:

  • Retrospective cohort study of 204 patients with SMCP and VPD.
  • Data collected from a single academic medical center between 2002 and 2008.
  • Multilevel mixed-effects models used to analyze speech score trajectories, adjusting for covariates.

Main Results:

  • Presurgical speech scores in SMCP patients were predicted to decrease significantly over time (0.78 points/year).
  • Nonsurgical patients showed a slower predicted decrease in speech scores (0.23 points/year), but improvement was not significant within the critical speech development window.
  • Surgical patients' postsurgical speech scores showed a minimal predicted decrease (-0.04 points/year), indicating stabilization or improvement post-intervention.

Conclusions:

  • While speech can improve without surgery, it's unlikely to occur within the critical period for speech development.
  • Surgical intervention significantly enhances speech production rates in patients with SMCP and VPD.
  • Early surgical management is recommended to optimize speech outcomes in children with SMCP and VPD.