A Study of Velopharyngeal Competence in Children with Repaired Cleft Palates

Abstract

There is a lack of agreement among surgeons who close palatal clefts regarding choice of surgical procedure and age of the child at which surgery is performed. At the present time there is no uniform or standard method of evaluating velopharyngeal competency that is universally accepted. It would be helpful if a simple, yet reliable and valid, means could be found by which results for different surgeons using different techniques and for children of different ages could be compared. One such possible means might be the use of a pressure gauge to test blowing and sucking abilities of their patients. The purpose of the present study was to describe the per— formances of a group of children who have cleft palates on measures of nasality and pressure tasks, compare those performances with those of normal children, and investigate the interrelationships among the measures employed. Hypernasality has been reported by several investigators (2, 3, 5, '7, 9, 10) to be characterized by the reinforcement of certain resonance areas. There has not been general agreement, however, as to which frequencies are reinforced. Formant frequencies and amplitudes were measured from sound spectrograms in this study for the purpose of locating possible areas of reinforcement of the cleft palate speakers. Procedure SUBJECTS. Twenty-eight children with repaired complete unilateral clefts of the lip and palate constituted the experimental group. Their ages ranged from four years, eight months, to ten years, six months. The mean age was seven years, one month. All had received surgery to close the cleft lip within the first month of life, and all received V-Y surgical techniques at approximately one year of age. Dr. William McEvitt performed all the operations in Detroit medical hospitals. Of the total of 54 children that qualified for inclusion in the experimental group, the 28 subjects selected were those who had not moved from the area and who were willing to coop— erate. There were 18 boys and 10 girls. Six had received no speech training, five had received less than six months of training, 14 had received from four Dr. Hanson is Director of the