Pharyngeal bulb reduction program in individuals with cleft palate

• Grant number: 20/05124-3
• Support type: Regular Research Grants
• Duration: November 01, 2020 - October 31, 2022
• Field of knowledge: Health Sciences - Speech Therapy
• Principal researcher: Maria Inês Pegoraro Krook
• Grantee: Maria Inês Pegoraro Krook
• Home Institution: Hospital de Reabilitação de Anomalias Craniofaciais (HRAC). Universidade de São Paulo (USP). Bauru , SP, Brazil
• Assoc. researchers: Ana Paula Fukushiro ; Homero Carneiro Aferri ; Jeniffer de Cássia Rillo Dutka ; Laura Katarine Félix de Andrade ; Maria Daniela Borro Pinto ; Melina Evangelista Whitaker ; Mônica Moraes Waldemarin Lopes ; Olivia Mesquita Vieira de Souza

Abstract

Introduction: The present study hypothesizes that certain patients treated with a pharyngeal bulb prosthesis associated with an intensive speech therapy program may develop an increase in velopharyngeal muscle activity during speech, to the point of considerably reducing (or even eliminating) the velopharyngeal gap. When this happens, surgery (as well as the choice of surgical technique) can then be successfully indicated. The reduction of the bulb involves the interdisciplinary work of the dentist (who will wear out the pharyngeal bulb until reach the desired number of reductions), and the speech therapist (who will guide the dentist on the bulb reductions and perform the speech therapy during the pharyngeal bulb reduction program). Objectives: a) Describe a pharyngeal bulb reduction program (PRB) to reduce the size of the velopharyngeal gap of individuals with operated cleft palate; b) Verify the effect of the PRB on the speech resonance of individuals with operated cleft palate, with regard to the perceptual-auditory evaluation of the occurrence of hypernasality and hyponasality, and the nasometric findings; c) Verify the effect of the PRB on the nasoendoscopic findings related to the velopharyngeal gap of individuals with operated cleft palate; d) Verify the effect of the PRB on the pharyngeal bulb configuration. Material and Methods: The caseload will consist of a minimal of 10 patients (both genders), from a convenience sample base consisting of patients presenting with operated cleft palate who underwent prosthetic treatment of velopharyngeal insufficiency. Patients who fulfill the inclusion criteria will undergo the PRB, which will consist of the following tasks: pharyngeal bulb reductions during nasoendoscopy, intensive speech therapy sessions after each bulb reduction, perceptual-auditory evaluation of speech, nasometry, evaluation of velopharyngeal function by means of flow-pressure technique, as well as measurements of the bulb configuration (length, width, area, volume, and weight), pre and post-bulb reductions. (AU)