[Perceptive and instrumental examination of voice quality in patients with lip-jaw-palate clefts].
BACKGROUND
In Anglo-American literature, prevalences as high as 41% are reported for voice disorders in cleft lip and palate (CLP) patients. Because of considerable variability in the reported findings and because no prevalence data are available for the German-speaking area, a screening study was conducted.


METHODS
154 patients with CLP were examined. Voice quality was assessed perceptively according to the rbh-system (roughness, breathiness, hoarseness). Suprasegmentals and nasal resonance were also assessed. Using a new computer programme for the apparative analysis of voice quality, data for pitch, intensity and pertubation (jitter and shimmer) were obtained for 4 sustained vowels.


RESULTS
Based on perceptual analysis, we found that the prevalence of severe voice disorders in CLP patients was 6.5% which is lower than reported in most other studies. The incidence of voice disorders in CLP patients is numerically only slightly higher than in the normal population. The acoustic measurements confirm the results of perceptual analysis. Since the prevalence of severe voice disorders was low, none of the pertubation quotients differentiated between modal and disordered voices. A weak correlation was found between jitter and the ratings for hoarseness.


CONCLUSIONS
1. While it is appropriate to assume a higher potential risk for vocal dysfunction in CLP patients the actual prevalence in the patients examined is numerically only slightly higher than in normals. 2. For patients with voice disorders, apparative diagnostics of voice quality is a useful and practical adjunct to perceptual analysis which helps profiling individual patients and helps the professional to make decisions for therapy.
Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie, Technischen Universität München. tbressma@mlg.med.tu-muenchen.de
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T
Bressmann
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Sader
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Merk
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Ziegler
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Busch
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Zeilhofer
H H
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Horch
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002971:Cleft Lip / Q000175:diagnosis*; D002972:Cleft Palate / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013018:Sound Spectrography; D013068:Speech Production Measurement; D014832:Voice Disorders / Q000175:diagnosis*; D014833:Voice Quality