title: Speech intelligibility of patients with cleft lip and palate after placement of speech prosthesis.
abstract: OBJECTIVE
  To evaluate the speech intelligibility of patients with clefts before and after placement of a speech prosthesis.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, Brazil.
  
  
  METHODS
  Twenty-seven patients with unoperated cleft palate or operated cleft palate presenting with velopharyngeal insufficiency (VPI) after primary palatoplasty, treated with speech prosthesis, aged 8 to 63 years.
  
  
  METHODS
  Patients were fitted with palatopharyngeal obturators or pharyngeal bulbs, suitable to their dental needs. Five speech-language pathologists blindly evaluated speech samples of the patients with and without the prosthesis.
  
  
  METHODS
  Classification of speech samples according to a scoring system developed for speech intelligibility problems: 1 (normal), 2 (mild), 3 (mild to moderate), 4 (moderate), 5 (moderate to severe), and 6 (severe). Results were evaluated by the calculation of means of all judges for each patient in both situations.
  
  
  RESULTS
  The judges presented significant agreement (W=.789, p<.01). Speech intelligibility was significantly better after placement of the prosthesis for both unoperated patients (Z=1.93, p=.02) and operated patients with VPI after primary palatoplasty (Z=1.78, p=.03).
  
  
  CONCLUSIONS
  Speech intelligibility may be improved by rehabilitation of patients with cleft palate using a speech prosthesis. Speech therapy is needed to eliminate any compensatory articulation productions developed prior to prosthetic management.
authors.affiliation: Department of Prosthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Brazil. joaoh@centrinho.usp.br
authors.forename: João Henrique Nogueira
authors.initials: JH
authors.lastname: Pinto
authors.forename: Gisele
authors.initials: G
authors.lastname: da Silva Dalben
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Pegoraro-Krook
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002971:Cleft Lip / Q000503:physiopathology / Q000628:therapy*; D002972:Cleft Palate / Q000503:physiopathology / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010158:Palatal Obturators; D013065:Speech Intelligibility; D018709:Statistics, Nonparametric; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology / Q000628:therapy*