Comparison of Velopharyngeal Closure and Perceptual Speech Characteristics in Individuals with Submucous Cleft Palate

Abstract

The submucous cleft palate is a congenital condition which is characterized by an abnormal attachment of soft palate muscles to the hard palate. These individuals are at risk for abnormal speech characteristics such as hypernasal resonance, nasal air emission, and articulatory errors. Other symptoms may include persistent middle ear problems and swallowing difficulties. The present study is aimed to study the velar anatomy and function using Cineradiographic procedure and its association with perceptual speech characteristics of individuals with unoperated submucous cleft palate. 10 individuals with submucous cleft palate in the age range of 7 to 18 yrs (7 males and 3 females) were considered for the study. The speech samples consisted of vowels, high pressure words and standardized oral sentences. Right lateral cineradiographic videos were obtained for all the speech samples and were rated by three speech language pathologist for velar anatomy and function. For perceptual analysis of speech, the same samples were audio recorded in a quiet room and were presented to the same judges for perceptual rating. The results showed that all the subjects considered had inadequate velopharyngeal closure (56%). There was significant strong negative correlation for degree of velopharyngeal closure with hypernasality (rs=-0.68) and nasal air emission (rs=-0.71). No significant correlation for speech intelligibility and voice with velopharyngeal closure. Inter judge reliability had a higher internal consistency for all the perceptual speech parameters. The results indicated that both velar function and perceptual speech characteristics provide vital information that will be helpful in diagnosis and management of individuals with submucous cleft palate