Aspectos da fala de indivíduos com fissura palatina e labial, corrigida em diferentes idades
Aspects of speech of subjects with cleft palate corrected in different ages
Bianca Brito Novaes Palandi; Zelita Caldeira Ferreira Guedes
Resumo
Objetivo: comparar indivíduos com fissura labiopalatina que realizaram correção cirúrgica em diferentes idades e verificar quais os fatores intervenientes mais importantes nas alterações da fala.
Métodos: a amostra é composta por 29 indivíduos que nasceram com fissura labiopalatina e foram submetidos à correção cirúrgica em diferentes idades, sem outros comprometimentos associados (neurológicos, físicos, psicológicos, etc). Estes indivíduos foram avaliados sem se levar em consideração a etiologia e o tipo de malformação encontrado. Sendo que 13 do sexo masculino e 16 do sexo feminino possuem idades variando de seis a 13 anos de idade. Os indivíduos são do ambulatório de Distúrbios da Comunicação Humana de uma Universidade Pública Federal e do ambulatório de Cirurgia Plástica de um Hospital Público que ainda não entraram em terapia fonoaudiológica. A fala, desses indivíduos, foi avaliada pelo Teste de Fonologia (capítulo 1 do ABFW, Teste de Linguagem Infantil), e por meio da nomeação foi analisada a fala dos indivíduos. A nomeação foi feita com figuras simples que foram mostradas a eles.
Resultados: os resultados do presente estudo quanto ao sexo e o tipo de fissura da amostra não apresentaram resultados estatisticamente significantes. Entretanto, a época tardia em que ocorreu a cirurgia reparadora interferiu de forma negativa para emissão de fala desses pacientes.
Conclusões: com base nos resultados obtidos da análise da fala de indivíduos com fissura labiopalatina, pode-se concluir que um fator interveniente importante para a sua fala é a idade em que é realizada a cirurgia corretiva.
Palavras-chave
Abstract
Purpose: to compare individuals with cleft lip and palate who underwent surgical correction at different ages and to identify the most important intervening factors in speech disorders.
Methods: the sample consisted of 29 individuals born with cleft lip and palate who underwent surgical correction at different ages, without other associated impairments (neurological, physical, psychological, etc.). These individuals were evaluated without considering the etiology and type of malformation found. Of these, 13 were male and 16 female, aged between 6 and 13 years. The individuals were from the Human Communication Disorders outpatient clinic of a Federal Public University and the Plastic Surgery outpatient clinic of a Public Hospital who had not yet undergone speech therapy. The speech of these individuals was evaluated using the Phonology Test (chapter 1 of ABFW, Child Language Test), and through naming, the individuals' speech was analyzed. Naming was done with simple figures shown to them.
Results: the results of the present study regarding gender and type of cleft in the sample did not show statistically significant results. However, the late timing of the corrective surgery negatively interfered with the speech production of these patients.
Conclusions: based on the results obtained from the speech analysis of individuals with cleft lip and palate, it can be concluded that an important intervening factor for their speech is the age at which corrective surgery is performed.
Keywords
References
1. Cardim VL. Crescimento craniofacial In: Altman EBC: Fissuras labiopalatinas. 4. ed. Carapicuiba: Pro-Fono; 1997. p. 313-47.
2. Nagem Filho H, Moraes N, Rocha RGF. Contribuicao para o estudo da prevalencia das mas formacoes congenitas labio-palatais na populacao escolar de Bauru. Rev Fac Odontol. 1968; 6:111-28.
3. Spina V, Psillakis JM, Lapa FS. Classificacao das fissuras labiopalatinas: sugestao de modificacao. Rev Hosp Clin Fac Med. 1972; 27(1):5-6.
4. Kaplan, EN. The occult submucous cleft palate. Cleft Palate J. 1975; 12:356-685.
5. De Bodt M, Van Lierde K. Cleft palate speech and velopharyngeal dysfunction: the approach of the speech therapist. B-ENT. 2006; 2(Suppl4):63-70.
6. Henningsson G, Kuehn DP, Sell D, Sweeney T, Trost-Cardamone JE, Whitehill TL. Speech Parameters Group. Universal parameters for reporting speech outcomes in individuals with cleft palate. Cleft Palate Craniofac J. 2008 Jan; 45(1):1-17.
7. Hodge M, Gotzke CL. Preliminary results of an intelligibility measure for English-speaking children with cleft palate. Cleft Palate Craniofac J. 2007 Mar; 44(2):163-74.
8. Brunnegard K, Lohmander A. A cross-sectional study of speech in 10-year-old children with cleft palate: results and issues of rater reliability. Cleft Palate Craniofac J. 2007 Jan; 44(1):33-44.
9. Lohmander A, Persson C. A longitudinal study of speech production in Swedish children with unilateral cleft lip and palate and two-stage palatal repair. Cleft Palate Craniofac J. 2008 Jan; 45(1):32-41.
10. Wiedemer ML, Santos LF, Goncalves C. Fonemas plosivos e fricativos na fala de portadores de fissura labio-palatina - Revista Eletronica do Instituto de Humanidades. Abr - Jun 2008; 7 (25): 123-39.
11. Lima MRF, Leal FB, Araujo SVS, Matos EF. Atendimento fonoaudiológico intensivo em pacientes operados de fissura labiopalatina: relato de casos. Rev. soc. bras. fonoaudiol. 2007; 12(3):240-6.
12. Joos U, Wermker K, Kruse-Loesler B, Kleinheinz J. Influence of treatment concept, velopharyngealplasty, gender and age on hypernasality in patients with cleft lip, alveolus and palate. J Craniomaxillofac Surg. 2006 Dec; 34(8):472-7.
13. Genaro KF, Yamashita RP, Trindade IEK. Avaliacao clinica e instrumental na fissura labiopalatina. In: Ferreira LP, Befi-Lopes DM, Limongi SCO, organizadores. Tratado de fonoaudiologia. Sao Paulo: Roca; 2004. p.456-77.
14. Persson CSLP, Elander AMD, Anette Lohmander-Agerskov SLP, Soderpalm ESLP. Speech in Children With an Isolated Cleft Palate: A Longitudinal Perspective. Cleft Palate-Craniofac J. 2006; 43(3):295-309.
15. Jones CEMS, Chapman KL, Hardin-Jones MA. Speech development of children with cleft palate before and after palatal surgery. Cleft Palate-Craniofac J. 2003; 40(1):19-31.
16. Penido FA, Noronha RMS, Caetano KI, Jesus MSV, Di Ninno CQMS, Britto ATBO. Correlacao entre os achados do teste de emissao de ar nasal e da nasofaringoscopia em pacientes com fissura labiopalatina operada. Rev. soc. bras. Fonoaudiol. 2007; 12(2): 126-34.
17. Rego MVNN, Thiesen G, Rizzatto SMD, Menezes LM. Fissura bilateral completa de labio e palato: alterações morfológicas encontradas. Rev Odonto Cienc. 2003; 18(42):309-22.
18. Inge EK, Trindade BS, Bertier CE; Sampaio-Teixeira ACM. Assessment of Internal Nasal Dimensions and Speech Resonance in Individuals With Repaired Unilateral Cleft Lip and Palate After Rhinoseptoplasty. Journal of Craniofacial Surgery. 2009; 20(2): 308-14.
19. Lessa S, Carreirão S. Tratamento das fissuras labiopalatinas. 2. ed. Rio de Janeiro: Revinter; 1996.
20. Silva Filho OG, Calvano F, Assunção AG, Cavassan AO. Craniofacial morphology in children with complete unilateral cleft lip and palate: a comparison of two surgical protocols. Angle Orthod 2001;71(4):274-84.
21. Konst EM, Rietveld T, Herman PFM, Hanny Weersink-Braks MA. Use of a perceptual evaluation instrument to assess the effects of infant orthopedics on the speech of toddlers with cleft lip and palate. Cleft Palate-Craniofac J. 2003; 40(6):597-605.
22. Konst EM, Prahl CDDS, Hanny Weersink-Braks MA, De Boo TMSc, Birte Prahl-Andersen DDS, Kuijpers-Jagtman AMDDS, et al. Cost-effectiveness of infant orthopedic treatment regarding speech in patients with complete unilateral cleft lip and palate: a randomized three-center trial in the Netherlands (Dutchcleft). Cleft Palate-Craniofac J. 2004; 41(1):71-7.
23. Merrick GD, Kunjur J, Watts R, Markus A F. The effect of early insertion of grommets on the development of speech in children with cleft palates. Br J Oral Maxillofac Surg. 2007 Oct; 45(7):527-33.
24. Hardin-Jones M, Chapman KL. The impact of early intervention on speech and lexical development for toddlers with cleft palate: a retrospective look at outcome. Lang Speech Hear Serv Sch. 2008 Jan; 39(1):89-96.
25. Wertzner HF. Fonologia. In: Andrade CRF, Befi-Lopes DM, Fernandes FDM, Wertzner HF. ABFW; teste de linguagem infantil e nas áreas de fonologia, vocabulário, fluência e pragmática. Carapicuíba: Pró-Fono; 2000. p 1- 40.
26. Lohlander A, Friede H, Elander A, Persson C, Lilja J. Speech development in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair: a longitudinal perspective. Scand J Plast Reconstr Surg Hand Surg. 2006; 40(5):267-74.
27. Hardin-Jones MA, Jones DL. Speech production of preschoolers with cleft palate. Cleft Palate-Craniofac J. 2005; 42(1):7-13.
28. Schuster M, Maier A, Haderlein T, Nkenke E, Wohlleben U, Rosanowski F, Eysholdt U, Nöth E. Evaluation of speech intelligibility for children with cleft lip and palate by means of automatic speech recognition. International Journal of Pediatric Otorhinolaryngology, 2006; 70(10):1747.
Submitted date:
06/03/2009
Accepted date:
07/13/2010
Facebook
Twitter
LinkedIn
Mendeley
Email