Can peripheral hearing justify the speech disorders in subject with operated cleft palate?

Author(s)

Jaqueline Lourenço Cerom

• Document type: Master's Dissertation
• Press: Bauru.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia de Bauru (FOB/SDB)
• Defense date: 2013-03-27

Examining board members

Mariza Ribeiro Feniman; Lilian Cássia Bornia Jacob Corteletti; Sílvia Helena Alvarez Piazentin Penna

• Advisor: Mariza Ribeiro Feniman

Abstract

Scientific studies report that cleft lip and palate is one of the most common congenital malformations in the human race. This population, when compared to those without cleft lip and palate, show higher occurrence of hearing loss, otologic complications, velopharyngeal dysfunction and compensatory articulation dysfunction in speech, which are risk indicators for the hearing development, language, speech learning processes. This study aims to verify the association between the velopharyngeal dysfunction, the compensatory articulation dysfunction and the peripheral hearing loss in people with operated cleft lip and palate. It inquires if speech alterations in patients with operated cleft lip and palate can be justified by the loss of hearing acuity. It consists of a retrospective study on the hearing and speech evaluation of 60 patients records with transforamen unilateral left cleft lip and palate, aged between 4 and 5 years at the time and registered in the HRAC-USP. Records were chosen randomly. Four groups, of 15 patients each, were organized. G1 presented velopharyngeal dysfunction (VPD) and compensatory articulation disorders (CADs), G2 without VPD and with CADs, G3 with VPD and without CADs and G4 without VPD and CADs. The otoscopies with positive alterations were prevalent in G1, with higher occurrence of retraction and opacification of the tympanic membrane. There were subjects submitted to some kind of microtologic procedure in all groups. More than 70% of the sample did not present auditory complaints. In the hearing history there was a higher occurrence of negative description for hearing loss. Groups of patients with cleft lip and palate with VPD or CAD\'s presented more hearing alterations, supported by the presence of hearing loss. It was no statistically significant, though. G4 presented higher occurrence of subjects with normal hearing (80%), whereas G1 presented the highest occurrence of hearing loss (60%). The conductive hearing loss presented the highest occurrence in all groups. The stroke of the glottis (more frequent), the pharyngeal fricative consonant, the velar fricative consonant (less frequent), the posterior nasal fricative consonant and the plosive mid-dorsum palatal were the compensatory articulation disorders. Results showed no significance when associating the presence of hearing loss with the presence of compensatory articulation disorders (p=0.05), as well as the presence of hearing loss with the presence of velopharyngeal dysfunction (p=0.12). However, when associated with hearing loss with the presence of compensatory articulation disorders and velopharyngeal dysfunction concomitantly statistical significance has been found (p=0,025). Association between the velopharyngeal dysfunction, the compensatory articulation disorders, and the peripheral hearing loss in the population with cleft lip and palate, when isolation analyzed, was not found. When the velopharyngeal dysfunction and compensatory articulation disorders showed by the same person, sta Statistical significance was found when associate with the presence of hearing loss. Further studies with bigger samples are suggested. It is essential to examine the association of the velopharyngeal dysfunction disorder with the central hearing abilities, aiming at illustrating the unknown questions in the diagnostic process in the future. It may provide favorable data to the intervention process of this population. (AU)

• FAPESP's process: 11/04222-2 - Can peripheral hearing justify the speech disorders in subject with operated cleft palate?
• Grantee: Jaqueline Lourenço Cerom
• Support Opportunities: Scholarships in Brazil - Master