Measurements of the maxillary arch primary pre-palatoplasty as predictors of results of speech in individuals with cleft lip and palate

Author(s)

Ana Flávia Rodrigues da Silva

• Document type: Doctoral Thesis
• Press: Bauru.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia de Bauru (FOB/SDB)
• Defense date: 2018-12-05

Examining board members

Maria Ines Pegoraro Krook; Giédre Berretin; Rui Manuel Rodrigues Pereira; Cristiano Tonello

• Advisor: Maria Ines Pegoraro Krook

Abstract

Objective: to verify the relationship between pre-palatoplasty maxillary arch measurements and speech results in unilateral cleft lip and palate individuals (UCLP). Methodology: the 139 patients (both genders) of the present study were selected from the caseload of 466 unilateral cleft lip and palate patients of the Florida Project maintained by the HRAC/USP, who presented the following selection criteria: no palatal fistula, with speech recordings between 3 and 6 years of age, and 3D-digitalized gypsum casts models performed pre-palatoplasty. Three experienced speech therapists perceptually evaluated the occurrence of hypernasality of the edited recorded speech samples. The results were compared with the occurrence of hypernasality evaluated face-to-face and with the scores of the Test of Hypernasality collected from patients medical records. The data were analyzed considering the surgical variables (surgeon, surgical technique, surgical time and gender) of each patient. Linear measurements of the maxillary arch (intercanine distance - DIC, intertuberosity distance - DIT, anteroposterior distance of the hard palate DAP, and posterior width of the cleft - LPF) and area measurements (from cleft - AF and blades greater - ALMa and minor - ALMe) were performed on the 3D-digitalized casts, using software 3 Shape Appliance Design 2013-1 and Mimics Research 17.0. The chi-square test was used to calculate the relationship between the results of the occurrence of hypernasality and the surgical variables. The t test was used for the relationship between the occurrence of hypernasality and the maxillary measurements. Results: with regard to the hypernasality evaluation of the: a) recorded samples: 86 (62%) patients did not present it and 53 (38%) presented it; b) face-to-face: 112 (81%) patients did not present it and 27 (19%) presented it; c) THIPER: 113 (81%) patients did not present it and 26 (19%) presented it. There was no statistically significant relationship between the occurrence of hypernasality for any of the methods evaluated (recordings, face-to-face and THIPER) and surgical variables. The mean of the maxillary measurements was 27.22 mm (SD = 2.72 mm) for DIC, 35.67 mm (SD = 2.65 mm) for DIT, 28.35 mm (SD = 2.7 mm) for DAP, 10.16 mm (SD = 2.76 mm) for LPF, 427.59 mm2 (SD = 203.4 mm2) for AF, 1335 mm2 (SD = 154.34 mm2) for ALMa, and 979.28 mm2 (SD = 147.56 mm2) for ALMe. Only the relation between the occurrence of hypernasality by recordings and the measurement of the AF was statistically significant (mean of 461.30 mm2 for patients presenting with hypernasality and 372.88 mm2 for patients without hypernasality, p = 0.01). Conclusion: AF was the only measure, among those studied, that could predict speech results in patients with UCLP (AU)

• FAPESP's process: 17/01382-5 - Measurements of the maxillary arch primary pre-palatoplasty as predictors of results of speech in individuals with cleft lip and palate
• Grantee: Ana Flávia Rodrigues da Silva
• Support Opportunities: Scholarships in Brazil - Doctorate