Noriko Ainoda

Articulation at age 4 in children with early repair of cleft palate.

We report the articulation results in 87 4-year-old children with overt cleft palates who had been repaired at age 1 by the same surgeon and were found to have no factors obstructing their speech-language development. We further present data on developmental courses before age 4 in 81 subjects and after age 4 in 64 subjects. Forty-five of the 87 subjects showed normal articulation: 24 had already acquired normal speech sounds and 21 were still in the course of normal development. In this group only 1 patient showed incompetent velopharyngeal closure. Abnormal articulation was found in 42, among whom only 4 showed incompetent velopharyngeal closure. The most common abnormal articulatory type was palatalized articulation (70%), which had been seldom found in earlier studies. Palatalized articulation showed less of a tendency to correct itself spontaneously than did glottal stops. Abnormal articulation improved spontaneously after 4 years of age in some subjects. The significance of detailed postsurgical follow-up and the necessity of accumulation of more data are emphasized.

Results of Systematic Speech Sound Monitoring in Children with Cleft Palate

Using our monitoring system, we report the articulation results in 208 children with competent velopharyngeal function after surgery of cleft palate. The number of children who showed normal articulation at each test during the monitoring period was 138. The other 79 children included 37 who acquired normal articulation after training and whose misarticulation disappeared without training. Factors related to their misarticulation are discussed.

Palatal pushback and lateral pharyngoplasty in surgical management of submucous cleft palate

SummaryThe methods and the results of palatal pushback and lateral pharyngoplasty on SMCP were described. Of 26 patients with VP incompetence followed up for more than 6 months after operation, 23 (88%) improved at average 2.9 postoperative months (0.5 ∼ 8 months) and three were unchanged at 7, 10, and 24 postoperative months. In these three patients their VP sphincter orifice was more than 10 mm2. It was, therefore, considered necessary to decide to construct the VP sphincter orifice size between approximately 10 and 12 mm. Anatomical condition and VP closure in SMCP were markedly variable from patient to patient. Cases with marked anatomical variation or poor prognosis through speech training must undergo operation as early as possible.

Velopharyngeal Closure Function and Speech in the Submucous Cleft Palate

SummaryPrevious studies have shown that SMCP involves a wide range of velopharyngeal (VP) closure functions and speech problems. However, the criteria of these analyses have not always been presented clearly. In this study we analyzed the VP closure function and speech in 40 classical triad SMCP patients according to definite categories. The results showed that 16 had competent VP closure function, including 6 with complete and 10 with marginal closure function. Six had normal speech with normal voice resonance and articulation. The factors related to this variety are discussed.