In:
Folia Phoniatrica et Logopaedica, S. Karger AG, Vol. 74, No. 4 ( 2022), p. 271-283
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Abnormal facial growth is a recognized outcome in cleft lip and palate (CLP), resulting in a concave profile and a class III occlusal status. Maxillary osteotomy (MO) is undertaken to correct this facial deformity, and the surgery can impact speech articulation, although the evidence remains limited and ill-defined for the CLP population. 〈 b 〉 〈 i 〉 Aims: 〈 /i 〉 〈 /b 〉 The aim of the study was to investigate the impact of MO on the production of the fricatives /f/ and /s/, using perceptual and acoustic analyses, and to explore the nature of speech changes. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Twenty participants with CLP were seen 0–3 months pre-operatively (T1) and 3 months (T2) and 12 months (T3) after MO. A normal group ( 〈 i 〉 N 〈 /i 〉 = 20) was similarly recruited. Perceptual speech data was collected according to a validated framework and ratings made on audio and audio-video recordings (VIDRat). Spectral moments were centre of gravity (CG), standard deviation (SD), skewness (SK) and kurtosis (KU). Reliability studies were carried out for all speech analyses. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 For the CLP group, VIDRat identified dentalization/interdentalization as the main type of pre-operative error for /s/ with a statistically significant improvement over time, χ 〈 sup 〉 2 〈 /sup 〉 (2) = 6.889, 〈 i 〉 p 〈 /i 〉 = 0.032. Effect sizes were medium between T1 and T3 ( 〈 i 〉 d 〈 /i 〉 = 0.631) and small between T2 and T3 ( 〈 i 〉 d 〈 /i 〉 = 0.194). For the acoustic data, effect sizes were similarly medium between T1 and T2 (e.g., SK, /f/ 〈 i 〉 d 〈 /i 〉 = 0.579, /s/ 〈 i 〉 d 〈 /i 〉 = 0.642) and small between T1 and T3 across all acoustic parameters. Independent 〈 i 〉 t 〈 /i 〉 tests showed mainly statistically significant differences between both groups at all time points with large effect sizes (e.g., T2 CG, 〈 i 〉 t 〈 /i 〉 = –4.571, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001, 〈 i 〉 d = 〈 /i 〉 1.581), indicating that /s/ was not normalized post-operatively. For /f/, differences tended to be at T1 with large effect sizes (e.g., CG, 〈 i 〉 t 〈 /i 〉 = –2.307, 〈 i 〉 p 〈 /i 〉 = 0.028, 〈 i 〉 d 〈 /i 〉 = 0.797), reflecting normalization. 〈 b 〉 〈 i 〉 Conclusions and Implications: 〈 /i 〉 〈 /b 〉 This is the first speech acoustic study on /f/ for individuals with CLP undergoing MO. The surgery has a positive impact on /f/ and /s/, which appear to stabilize 3 months post-operatively. Speech changes are an automatic and a direct consequence of the physical changes brought about by MO, effecting articulatory re-organization. The results of the study have direct clinical implications for the clinical care pathway for patients with CLP undergoing MO.
Type of Medium:
Online Resource
ISSN:
1021-7762
,
1421-9972
Language:
English
Publisher:
S. Karger AG
Publication Date:
2022
detail.hit.zdb_id:
1482295-7
SSG:
7,11
Permalink
