Speech intelligibility of patients with cleft lip and palate after placement of speech prosthesis.
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.
Pinto
João Henrique Nogueira
JH
Department of Prosthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Brazil. joaoh@centrinho.usp.br
da Silva Dalben
Gisele
G
Pegoraro-Krook
Maria Inês
MI
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*