Effect of perceptive-auditory training on the classification of speech hypernasality.

Purpose: To analyze the effect of auditory-perceptual training by inexperienced speech-language pathologists in the classification of hypernasality in individuals with cleft lip and palate and compare their classification of hypernasality individually, with the gold standard evaluation, before and after this training.

Methods: Three inexperienced speech-language pathologists used a four-point scale to assess 24 high-pressure speech samples from individuals with cleft lip and palate, before and after auditory-perceptual training. The speech samples corresponded to six samples of each degree of hypernasality.

Influence of an Intensive Speech Therapy Program on the Speech of Individuals with Cleft Lip and Palate.

 Compensatory articulations are speech disorders due to the attempt of the individual with cleft palate/velopharyngeal dysfunction to generate intraoral pressure to produce high-pressure consonants. Speech therapy is the indicated intervention for their correction, and an intensive speech therapy meets the facilitating conditions for the correction of glottal stop articulation, which is the most common compensatory articulation.  To investigate the influence of an intensive speech therapy program (ISTP) to correct glottal stop articulation in the speech of individuals with cleft palate.

Cephalometric predictors of hypernasality and nasal air emission.

Background: During times of increasingly recognized importance of interprofessional practices, professionals in Medicine, Dentistry, and Speech Pathology areas cooperate to optimize treatment of velopharyngeal dysfunction (VPD), after primary palatoplasty for correction of cleft palate.

Objective: Our study aims to compare velar length, velar thickness, and depth of the nasopharynx of patients with unilateral cleft lip and palate (UCLP) with the presence, or absence, of hypernasality and nasal air emission; and to verify if the depth:length ratio, between nasopharynx and velum, would be predictive of consistent hypernasality and nasal air emission (speech signs of VPD).

Methodology: Cephalometric radiographs and outcome of speech assessment were obtained from 429 individuals, between 6 and 9 years of age, with repaired unilateral cleft lip and palate.

Long-Term Outcome With an Active Middle Ear Implant in Patients to Bilateral Aural Atresia.

Objective: To describe the audiological results and complications following active middle ear implant (AMEI) surgery in users with bilateral ear atresia.

Study Design: Observational and retrospective longitudinal follow-up.

Setting: A tertiary referral hospital for hearing rehabilitation and craniofacial malformations.

Influence of speech stimuli in the auditory perceptual identification of hypernasality in individuals with cleft lip and palate.

Purpose: To investigate the influence of speech stimuli in the auditory perceptual identification of hypernasality in individuals with Cleft Lip and Palate (CLP).

Methods: Speech samples from 80 individuals with operated unilateral CLP, ages ranged from nine to 17 years (the mean age of: 12y7m), both genders, were edited for this study. Samples were recorded over the production of nine different speech stimuli, including counting and short sentences characterized by oral sounds, one loaded with low pressure consonants and seven loaded with high pressure consonants.

Influence of surgical technique and timing of primary repair on interarch relationship in UCLP: A randomized clinical trial.

Objective: To compare dental arch relationships in children with unilateral cleft lip and palate (UCLP) between two surgical techniques for repair of cleft lip/palate and two ages of palate repair.

Settings And Sample: Dental models were taken for a group of 448 subjects at a mean age of 7 years and were evaluated by means of the Goslon Yardstick. The patients studied consisted of an initial group of 673 infants with complete UCLP randomized into 8 study groups according to lip repair procedures (Millard versus Spina techniques); palate repair procedures (von Langenbeck versus Furlow techniques); and palate repair timing (early: 9 to 12 months versus late: 15-18 months).

Management of acquired cholesteatoma in patients with craniofacial anomalies: An institutional experience.

Purpose: To analyze the surgical management of cholesteatoma in patients with craniofacial abnormalities, cleft lip/palate by reviewing the institutional experience. The secondary aim was to identify and describe the epidemiological profile of the collected data, and to relate the cleft palate and cholesteatoma.

Design And Methods: This retrospective chart review includes 97 patients with craniofacial abnormalities and acquired cholesteatoma with anatomopathological proven in 118 ears.

Is the early mixed dentition dental arch relationship related to the anteroposterior alignment of the maxillary segments in infants with CUCLP?

Objective: Midface retrusion is a concern in patients with complete unilateral cleft lip and palate (CUCLP). Maxillary segment alignment may influence the prognosis after corrective surgery. This study assessed the association between maxillary segment alignment and interarch relationship observed in the early mixed dentition.

Nasalance-Based Preclassification of Oral-Nasal Balance Disorders Results in Higher Agreement of Expert Listeners' Auditory-Perceptual Assessments: Results of a Retrospective Listening Study.

Objective: Reliable perceptual and instrumental assessment of oral-nasal balance disorders is a persistent problem in speech-language pathology. The goal of the study was to evaluate whether nasalance-based preclassification of oral-nasal balance disorders improves listener agreement.

Design: Retrospective listening study.

Normative Nasalance Scores for Middle-Aged and Elderly Speakers of Brazilian Portuguese.

Objectives: This study establishes normative nasalance values for middle-aged and elderly Brazilian Portuguese-speakers and investigates age and gender effects across the life span.

Methods: Nasalance scores were obtained from 62 middle-aged (45-59 years) and 60 elderly (60-79 years) participants with normal speech for 3 nonnasal, 1 phonetically balanced, and 2 nasal-loaded test sentences using the Nasometer II 6400. The data were combined with a published data set of 237 speakers in 4 groups: children (5-9 years), adolescents (10-19 years), young adults (20-24 years), and mature adults (25-35 years).

Intensive treatment of speech disorders in robin sequence: a case report.

Purpose: To describe the speech of a patient with Pierre Robin Sequence (PRS) and severe speech disorders before and after participating in an Intensive Speech Therapy Program (ISTP).

Methods: The ISTP consisted of two daily sessions of therapy over a 36-week period, resulting in a total of 360 therapy sessions. The sessions included the phases of establishment, generalization, and maintenance.

Size of Velopharyngeal Structures After Primary Palatoplasty.

Objective: To describe and compare measures of velar length, velar thickness, and depth of the nasopharynx between two groups of patients with velopharyngeal dysfunction after primary palatoplasty: one received the modified Langenbeck procedure and the other the Furlow procedure.

Design: Comparative study involving a convenience sample of videofluoroscopic films established prospectively.

Setting: Surgeries and videofluoroscopic assessments were conducted at a craniofacial center.

Nasalance values for syllables produced by Brazilian Portuguese speakers.

Purpose: This study aimed to determine nasalance values for syllables produced by Brazilian Portuguese speakers of different ages and gender.

Methods: Nasalance scores were collected for 14 syllables (10 orals and 4 nasals) using Nasometer II 6400. The participants were 245 Brazilian Portuguese speakers (121 males and 124 females), both genders, divided into four age groups: 57 children, 61 adolescents, 65 young adults and 62 adults.

Multimedia material about velopharynx and primary palatoplasty for orientation of caregivers of children with cleft lip and palate.

Purpose: The objective of this study was to describe the process of elaboration and evaluation of multimedia material for caregivers about velopharynx, speech, and primary palatoplasty in babies with cleft lip and palate.

Methods: The elaboration of the material involved an interdisciplinary relationship between the fields of Speech Language Pathology and Audiology, Dentistry and Arts. The definition and execution of the following activities were based on the principles of art education involving the following: characterization of audience, characterization of content, identification and elaboration of illustrations, characterization of educational approach, elaboration of text and narratives, definition of audiovisual sequence, and video preparation.

Speech nasality and nasometry in cleft lip and palate.

Introduction: Perceptual evaluation is considered the gold standard to evaluate speech nasality. Several procedures are used to collect and analyze perceptual data, which makes it susceptible to errors. Therefore, there has been an increasing desire to find methods that can improve the assessment.

Nasoendoscopic findings after primary palatal surgery: can the Furlow technique result in a smaller velopharyngeal gap?

Purpose: To compare the nasoendoscopic findings related to the velopharyngeal gap among patients with cleft palate who underwent the Furlow (F) technique and those who underwent the von Langenbeck (vL) technique for primary palatal surgery, who remained with velopharyngeal insufficiency (VPI).

Methods: The analyzed data were retrieved from the institution's data of recordings of nasoendoscopic exams. The sample comprised 70 recorded nasoendoscopic exams obtained from 22 patients who underwent the F technique and from 48 who underwent the vL technique during primary palatoplasty, who remained with VPI after surgery and were submitted to nasoendoscopy, between the ages of 5 and 15 years (mean age: 8 years), for definition of the best treatment for VPI.

Teleducation about Cleft Lip and Palate: An Interdisciplinary Approach in the Promotion of Health.

Introduction The Young Doctor Project (YDP) uses Telehealth and Interactive Teleducation instruments to promote the integration of different areas of health and to build knowledge. This methodology can also foster public awareness on various issues related to health. In this context, the objective of this study was to emphasize cleft lip and palate (CLP), which is one of the most common birth defects in Brazil.

Assessment of speech nasality in children with Robin Sequence.

Purpose: 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.

Nasalance during use of pharyngeal and glottal place of production.

Purpose: This study obtained nasalance scores during use of compensatory articulation (CA) and compared nasalance between groups with and without hypernasality and with and without CA.

Methods: Speech samples were obtained from 43 individuals with and without velopharyngeal dysfunction during repetition of 20 phrases originating 860 audio recordings and their respective nasometric values. After excluding 143 recordings due to low quality, the remaining 717 samples were rated by three speech language pathologists (SLPs), independently, for presence or absence of hypernasality and CA.

Longitudinal study of growth of children with unilateral cleft lip and palate: 2 to 10 years of age.

Objective : To study the growth of children with complete unilateral cleft lip and palate (UCLP) from 2 to 10 years of age and to assess whether growth varied from that of children without UCLP (typical children). Design : Physical growth was one of the outcome measures of a National Institutes of Health-sponsored longitudinal, prospective clinical trial conducted by the University of Florida and the University of São Paulo. Setting : Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP), Bauru, Brazil.

Speech therapy for compensatory articulations and velopharyngeal function: a case report.

The objective of this study was to describe the process of intensive speech therapy for a 6-year-old child using compensatory articulations while presenting with velopharyngeal insufficiency (VPI) and a history of cleft lip and palate. The correction of VPI was temporarily done with a pharyngeal obturator since the child presented with very little movement of the pharyngeal walls during speech, compromising the outcome of a possible pharyngeal flap procedure (pharyngoplasty). The program of intensive speech therapy involved 3 phases, each for duration of 2 weeks incorporating 2 daily sessions of 50 minutes of therapy.

Nasalance and nasality at experimental velopharyngeal openings in palatal prosthesis: a case study.

Unlabelled: The use of prosthetic devices for correction of velopharyngeal insufficiency (VPI) is an alternative treatment for patients with conditions that preclude surgery and for those individuals with a hypofunctional velopharynx (HV) with a poor prognosis for the surgical repair of VPI. Understanding the role and measuring the outcome of prosthetic treatment of velopharyngeal dysfunction requires the use of tools that allow for documenting pre- and post-treatment outcomes. Experimental openings in speech bulbs have been used for simulating VPI in studies documenting changes in aerodynamic, acoustic and kinematics aspects of speech associated with the use of palatal prosthetic devices.