1/13. Speech patterns in Kabuki make-up syndrome: a case report.The case of a girl aged 3 years and 8 months with Kabuki make-up syndrome is reported. At presentation, she had normal cognitive functioning, and she also had a history of otitis media, a submucous cleft palate, and some hypotonia. language testing showed normal receptive skills and good expressive vocabulary but poor morphosyntactic abilities. Speech analysis showed that she was capable of producing most of the sounds of her native language but demonstrated high variability in production of the sounds. In addition, she inconsistently simplified words by application of several phonologic processes. Possible explanations for the communication problems demonstrated are discussed.- - - - - - - - - - ranking = 1keywords = cleft palate, palate, cleft (Clic here for more details about this article) |
2/13. magnetic resonance imaging in the evaluation of occult submucous cleft palate.OBJECTIVE: To explore the application of magnetic resonance imaging (MRI) in the evaluation of patients with occult submucous cleft palate and to use the MRI information obtained to aid in the treatment decision to perform surgery versus behavioral speech therapy. DESIGN: Prospective study with magnetic resonance (MR) images of subjects suspected of having occult submucous cleft palate. SETTING: Hospital and university-based. patients: Two girls who were 4 years old at the time of palatal surgery. INTERVENTION: Furlow double-opposing Z-plasty. MAIN OUTCOME MEASURES: MR images and clinical speech evaluations. RESULTS: MR images provided evidence of an interruption of levator veli palatini muscle tissue in the midline and a substantial attachment of levator muscle tissue to the posterior border of the hard palate. In addition, MR images for both subjects demonstrated remarkably similar bilateral encapsulating sheaths that contained nonmuscular tissue, as confirmed subsequently during surgery. The encapsulating sheaths interrupted the normal progression of the levator muscle sling across the midline. The MR images led to the decision to perform surgery instead of speech therapy. Hypernasality was markedly reduced in both subjects after surgery. CONCLUSIONS: MRI is an effective technique for diagnosing occult submucous cleft palate and may be an important aid in the treatment decision regarding surgery versus behavioral speech therapy for patients diagnosed with occult submucous cleft palate.- - - - - - - - - - ranking = 7.1669017917151keywords = cleft palate, palate, cleft (Clic here for more details about this article) |
3/13. Minimally invasive functional reconstruction after extended oropharyngeal resection including soft palate and base of tongue using a pectoralis major myocutaneous flap.Excision of large oropharyngeal carcinomas that affect the base of the tongue and the soft palate severely impairs swallowing and articulation. In the present study we describe a minimally invasive technique that effectively restores swallowing and articulation by the insertion of a pectoralis major myocutaneous flap with a bilobular skin island. One lobe of the skin island is used to reconstruct the base of the tongue and the other to reconstruct the oropharynx. The soft palate is reconstructed by folding the tip of the lobe that is used to reconstruct the oropharynx in half along the long axis to fill the rhinopharynx. We have done this procedure for 13 patients with oropharyngeal carcinoma. Six months postoperatively all 13 were able to swallow without aspiration. Nine of the 13 patients were able to hold a normal conversation, but the remaining four had severe rhinolalia aperta. However, this condition was easily corrected by secondary reconstruction using a pharyngeal flap and a palatal mucoperiosteal flap (n = 3) or by the use of a small speech aid (n = 1).- - - - - - - - - - ranking = 0.41568046481972keywords = palate (Clic here for more details about this article) |
4/13. Changes in linguapalatal contact patterns during therapy for velar fronting in a 10-year-old with Down's syndrome.BACKGROUND: Articulation errors in the speech of people with Down's syndrome are frequent and often resistant to speech therapy. This preliminary study investigates the use of electropalatography (EPG) to diagnose and treat abnormal articulation patterns associated with velar fronting in a 10-year-old girl. AIMS: The study measured changes in the accuracy and stability of linguapalatal (tongue-palate) contact patterns during a 14-week course of visual feedback therapy using EPG. Therapy aimed to resolve a pattern of velar fronting whereby targets /k, g, eta/ had alveolar placement [t, d, n]. methods & PROCEDURES: The participant was a girl (P) with Down's syndrome aged 10;11 years. P had a moderate-severe speech disorder, which included velar fronting. Her speech was recorded with EPG on three occasions during a 14-week course of therapy: first, before therapy; second, midway through therapy; and third, after therapy. Three analyses were conducted on the EPG data. The first used an EPG classification scheme that identified accuracy of placement for /t/ and /k/ targets. The second was a centre of gravity measure that detected whether P produced a significant difference between /t/ and /k/ targets. The third was a variability index that quantified the stability of contact patterns. OUTCOMES & RESULTS: The results of the EPG classification showed that before therapy, /t/ and /k/ targets had identical alveolar placement, reflecting the process of velar fronting. The results after therapy showed that 87% of /k/ targets had accurate velar placement. The centre of gravity measure showed no difference in contact patterns for /t/ and /k/ before therapy, but a statistically significant difference at the second and third recordings. The variability index showed stable contact patterns before therapy for /t/ and /k/ targets, but both became highly unstable midway through therapy, with a return to stability at the third recording. We embed a discussion of P's increased articulation instability during therapy in a recent theoretical framework--dynamic systems--that attempts to account for the emergence of new behavioural forms. CONCLUSIONS: These preliminary results suggest that EPG has potential as an effective diagnostic and therapy procedure for articulation errors in people with Down's syndrome. A major issue still to be addressed, however, is the extent to which others will benefit from this approach to intervention.- - - - - - - - - - ranking = 0.069280077469954keywords = palate (Clic here for more details about this article) |
5/13. Using electropalatography (EPG) to diagnose and treat articulation disorders associated with mild cerebral palsy: a case study.Some children with mild cerebral palsy have articulation disorders that are resistant to conventional speech therapy techniques. This preliminary study investigated the use of electropalatography (EPG) to diagnose and treat a long-standing articulation disorder that had not responded to conventional speech therapy techniques in an 8-year-old boy (D) with a congenital left hemiplegia. The targets for EPG therapy were speech errors affecting velar targets /k, g, eta/, which were consistently fronted to alveolar placement [t, d, n]. After 15 sessions of EPG therapy over a 4-month period, D's ability to produce velars improved significantly. The EPG data revealed two features of diagnostic importance. The first was an unusually asymmetrical pattern of tongue-palate contact and the second was unusually long stop closure durations. These features are interpreted as a subtle form of impaired speech motor control that could be related to a mild residual neurological deficit. The results suggest that EPG is of potential benefit for diagnosing and treating articulation disorders in individuals with mild cerebral palsy.- - - - - - - - - - ranking = 0.069280077469954keywords = palate (Clic here for more details about this article) |
6/13. Compensatory articulatory behaviours in adolescents with cleft palate: comparing the perceptual and instrumental evidence.A combination of perceptual and electropalatographic (EPG) analysis is used to investigate speech production in three adolescent speakers with a history of cleft palate. All the subjects still sound markedly atypical. Their speech output is analysed in three conditions: diadochokinetic tasks; single word production; connected speech. Comparison of the EPG and perceptual data reveals important lingual behaviours which were not identified by perceptual analysis alone. Lingualpalatal contact patterns previously noted in the speech of younger speakers with cleft palate are identified, as well as some lingual behaviours not previously reported in the literature. Similarities and differences between the individual speakers' profiles are discussed, as is the considerable inter- and intra-speaker variability identified in the data, and the speech output is discussed with reference to the notion of compensatory articulation.- - - - - - - - - - ranking = 6keywords = cleft palate, palate, cleft (Clic here for more details about this article) |
7/13. Immediate and sustained changes in tongue movement with an experimental palatal "fistula": a case study.OBJECTIVE: To determine the immediate and longer-term effect(s) on tongue movement following the placement of an experimental opening through a palatal obturator (replicate of subject's prosthesis) worn by an adult male with an unrepaired cleft of the hard and soft palate. methods: tongue movements associated with an anterior experimental opening of 20 mm(2) were examined under three conditions: a control condition in which the subject wore the experimental obturator completely occluded, a condition immediately after drilling the experimental openings through the obturator, and a condition after 5 days in which the subject wore the experimental obturator with the experimental opening. An Electromagnetic Articulograph was used for obtaining tongue movements during speech. RESULTS: The findings partly revealed that the immediate introduction of a perturbation to the speech system (experimental fistula) had a temporary effect on tongue movement. After sustained perturbation (for 5 days), the system normalized (going back toward control condition's behavior). Perceptual data were consistent with kinematic tongue movement direction in most of the cases. CONCLUSIONS: Although the immediate response can be interpreted as indicative of the subject's attempts to move the tongue toward the opening to compensate for air loss, the findings following a sustained perturbation indicate that with time, other physiological adjustments (such as respiratory adjustments, for example) may help reestablish the requirements of a pressure-regulating system.- - - - - - - - - - ranking = 0.097621714245179keywords = palate, cleft (Clic here for more details about this article) |
8/13. cleft palate in Kabuki syndrome: a report of six cases.Kabuki syndrome is a syndrome of rare congenital anomalies that was named after its characteristic appearance, a face resembling that of an actor in a Kabuki play. Although cleft palate is a feature that is sometimes observed in patients with Kabuki syndrome, there are few clinical reports of cleft palate associated with Kabuki syndrome. This report presents six cases of Kabuki syndrome with cleft palate and reviews their clinical features. Our results suggest that (1) patients with cleft palate in Kabuki syndrome tend to fail in acquiring normal velopharyngeal function and (2) submucous cleft palate might be more common in patients with Kabuki syndrome than previously was reported.- - - - - - - - - - ranking = 5.2771203098798keywords = cleft palate, palate, cleft (Clic here for more details about this article) |
9/13. An instrumental phonetic study of lingual activity in articulation-disordered children.Traditional auditory-based assessment procedures for diagnosing articulation disorders are limited in that they provide no direct information on activities of the speech organs. In this study electropalatography (EPG) was used to obtain details of tongue contacts with the hard palate in 4 articulation-disordered children, 2 of whom had been categorized as dysarthric. Their lingual-palatal contact patterns during four repetitions of word lists containing lingual consonants in different phonetic environments, were compared with each other and with a group of normal speakers. EPG provided relevant diagnostic information in that all 4 experimental subjects showed patterns that differed from the normals in both spatial configuration and variability. The nature of their distorted patterns allowed a tentative diagnosis of 2 of the children as verbal dyspraxic.- - - - - - - - - - ranking = 0.069280077469954keywords = palate (Clic here for more details about this article) |
10/13. Visual training and correction of articulation disorders by use of dynamic palatography: serial observation in a case of cleft palate.The dynamic palatograph is an electrical apparatus that generates a visual display of constantly changing palatolingual contact as a function of time, using an artificial palatal plate with affixed electrodes. This paper describes a technique of speech therapy incorporating dynamic palatography for a cleft palate patient. The patient, a 6-year-old Japanese girl with a repaired unilateral cleft lip and palate, had been judged to demonstrate articulation disorders involving contact of the tongue with the hard palate or alveolus following surgical improvement of velopharyngeal function. Prior to therapy the tongue tended to contact the hard palate more posteriorly than normal. After therapy with the dynamic palatograph, palatolingual contact was normal in comparison with average speakers. Our findings suggest that the facility of constant visual indication of tongue posture to the clinician and patient during corrective speech therapy using dynamic palatography may expedite results with cleft palate patients in the speech clinic when implemented in a carefully structured treatment plan.- - - - - - - - - - ranking = 6.2361818691851keywords = cleft palate, palate, cleft (Clic here for more details about this article) |
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