[Velopharyngeal sequels in labial-alveolar-velopalatine clefts. Analysis, conclusions and speech therapy management].
The association of voice and speech defines phonation. Phonation depends on various organs: the lungs for air, the larynx as a vibration generator, and cavities of resonance modeling articulation and tone. The role of the soft palate is important in French and for everyday conversation. Velopharyngeal incompetence is defined as a voice and articulation disruption by anatomic and/or functional deficiency between the soft palate and pharynx. Hypernasality is studied on an acoustic, phonetic, and vocal level and graded in various degrees of hypernasality. The various clinical and perceptive tests of velopharyngeal incompetence are described according to age. The difficulty to modelize hypernasality is discussed based on a recent study published in 2007. The differential diagnosis with hyper-closed nasality is discussed. The treatment for this condition is essentially speech therapy associated with pharyngoplasty in some cases. The assessment of children born with a labial-alveolar-velopalatine cleft is mainly clinical and perceptive. Therapeutic management is necessary for the child and his family. The follow-up requires a multidisciplinary approach.
Gaillot
A
A
Service de stomatologie-chirurgie maxillofaciale-chirurgie plastique de la face, CHU Hôtel-Dieu, boulevard Léon-Malfreyt, 63058 Clermont-Ferrand cedex 01, France. agaillot@chu-clermontferrand.fr
Mondie
J-M
JM
Buffard
F
F
Barthelemy
I
I
Sannajust
J-P
JP
D000367:Age Factors; D002648:Child; D002971:Cleft Lip / Q000150:complications*; D002972:Cleft Palate / Q000150:complications*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D010160:Palate, Soft / Q000503:physiopathology / Q000601:surgery; D010614:Pharynx / Q000503:physiopathology / Q000601:surgery; D010699:Phonation / Q000502:physiology; D013064:Speech Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013070:Speech Therapy; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014832:Voice Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy