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The Impact of Maxillary Advancement on Consonant Proficiency in Patients With Cleft Lip and Palate, Lay Listeners' Opinion, and Patients' Satisfaction With Speech
Karolinska Univ Hosp, Dept Reconstruct Plast Surg, Stockholm Craniofacial Team, Stockholm, Sweden.
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Basic Science. Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Speech & Language Pathol, Stockholm, Sweden.ORCID iD: 0000-0003-4129-9793
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2019 (English)In: The Cleft Palate-Craniofacial Journal, ISSN 1055-6656, E-ISSN 1545-1569, Vol. 56, no 4, p. 454-461Article in journal (Refereed) Published
Abstract [en]

Objective: This study investigates the impact of maxillary advancement (Le Fort Iosteotomy) on consonant proficiency in patients with cleft lip and palate (CLP) and explores how these patients and lay people perceive their speech 1 year post Le Fort I osteotomy. Design: Retrospective group study before and after treatment. Participants: All patients with CLP who had undergone Le Fort I osteotomy for maxillary retrognathia between 2007 and 2010 at Karolinska University Hospital, Sweden (n = 21). Six patients were excluded due to additional malformations and missing data. Two experienced speech and language pathologists assessed consonant proficiency, and speech accuracy was determined by lay listeners from pre- and postoperative standardized audio recordings. The patients' satisfaction with speech postoperatively was collected from medical records. Main Outcome Measures: Percentage of oral consonants correct and acoustic analysis of /s/, lay listeners' opinion, and patients' satisfaction with speech. Results: One year postoperation, 11 of the 15 patients had improved articulation, especially on the /s/-sound, without speech intervention. The mean percentage of oral consonants correct before treatment (82%) was significantly improved later (95%; P > .01). This assessment was supported by the patients' satisfaction with speech. However, lay listeners' opinion on accuracy was inconsistent. Length of maxillary advancement or change in occlusion did not correlate with change in articulation. Conclusion: Maxillary advancement performed to normalize occlusion and facial profile improved consonant proficiency in patients with CLP 1 year postoperation. Lay listeners' and patients' perceptions of speech need further exploration.

Place, publisher, year, edition, pages
NLM (Medline) , 2019. Vol. 56, no 4, p. 454-461
Keywords [en]
acoustics, articulation, dental occlusion, orthognathic surgery, osteotomy, speech production
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Medical and Health Sciences
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URN: urn:nbn:se:kth:diva-248330DOI: 10.1177/1055665618784804ISI: 000461717800003PubMedID: 29949386Scopus ID: 2-s2.0-85063296079OAI: oai:DiVA.org:kth-248330DiVA, id: diva2:1303219
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QC 20190409

Available from: 2019-04-09 Created: 2019-04-09 Last updated: 2019-04-09Bibliographically approved

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