title: Assessment of speech nasality in children with Robin Sequence.
abstract: OBJECTIVE
  To report the outcomes of primary palatoplasty in Robin Sequence (RS); to verify the relationship between modalities of assessment of nasality; to compare nasality between techniques at palatoplasty.
  
  
  METHODS
  This study involved the identification of hypernasality in four modalities: live assessment with 4-point scale; live assessment with cul-de-sac test; multiple listeners' ratings of recorded phrase; nasometric assessment. Live ratings of speech nasality and nasalance scores were retrieved from charts, while a recorded phrase was rated by listeners for occurrence of hypernasality. Agreement between the modalities was established as well as association between nasality, nasal turbulence and age at surgery and at assessment. Fisher's exact test was used to compare findings between surgical techniques.
  
  
  RESULTS
  Agreement between nasalance, live assessment with 4-point scale, live assessment with cul-de-sac, and multiple listeners' ratings of recorded samples ranged between reasonable (0.32) and perfect (1.00). Percentage occurrence of hypernasality varied largely between assessment modalities. Mean occurrence of hypernasality was lower for the group submitted to Furlow technique (26%) than the group that received von Langenbeck technique (53%). Only findings obtained live were statistically significant (scale: p=0.012; cul-de-sac: p<0.001). Listeners identified nasal turbulence for 22 (32%) samples out of the 69 recordings, and an association was found between hypernasality and nasal turbulence.
  
  
  CONCLUSIONS
  Lower occurrence of hypernasality was identified for patients with RS in Furlow group. Identification of hypernasality varied largely among the four assessment modalities.
authors.affiliation: Hospital of Rehabilitation for Craniofacial Anomalies, Universidade de São Paulo, Bauru, SP, Brazil.
authors.forename: Rosana
authors.initials: R
authors.lastname: Prado-Oliveira
authors.affiliation: Hospital of Rehabilitation for Craniofacial Anomalies, Universidade de São Paulo, Bauru, SP, Brazil.
authors.forename: Ilza Lazarini
authors.initials: IL
authors.lastname: Marques
authors.affiliation: School of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Luiz de
authors.initials: Ld
authors.lastname: Souza
authors.affiliation: Hospital of Rehabilitation for Craniofacial Anomalies, Universidade de São Paulo, Bauru, SP, Brazil.
authors.forename: Telma Vidoto de
authors.initials: TV
authors.lastname: Souza-Brosco
authors.affiliation: Hospital for Rehabilitation of Craniofacial Anomalies, Universidade de São Paulo, Bauru, SP, Brazil.
authors.forename: Jeniffer de Cássia Rillo
authors.initials: Jde C
authors.lastname: Dutka
mesh_terms: D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010855:Pierre Robin Syndrome / Q000534:rehabilitation* / Q000601:surgery; D013064:Speech Disorders; D013068:Speech Production Measurement / Q000145:classification / Q000295:instrumentation*; D014681:Velopharyngeal Insufficiency / Q000601:surgery; D014832:Voice Disorders / Q000175:diagnosis*; D014833:Voice Quality