Inteligibilidade de fala após palatoplastia primária: percepção do ouvinte

Abstract

Purpose: To verify the results of speech intelligibility in individuals submitted to primary palatoplasty, according to perceptual analysis by five examiners, experienced or not with the treatment of cleft lip and palate. Methods: Analysis of spontaneous speech records, registered in audiovisual system, of 78 individuals with repaired cleft lip and palate, of both genders, aged more than 4 years old, submitted to primary palatoplasty. The speech samples were analyzed by five different examiners, who scored the speech intelligibility using a three-point scale (1=good, 2=regu-lar, and 3=bad). The interexaminer agreement was assessed by the Kappa coefficient. The treatment success was analyzed descriptively regarding the proportion of patients according to the postoperative speech intelligibility, as determined by the examiners. Significance between differences was verified by the chi-square test (p<0.05). Results: The interexaminer agreement ranged from fair to substantial. Full agreement between the five examiners was observed in more than half of cases. Based on the mean values assigned by the examiners, a significant proportion of cases showed good speech intelligibility after palatoplasty. Conclusion: The present outcomes evidenced adequate speech intelligibility after primary palatoplasty in the majority of cases, suggesting that these individuals are well understood in their social environment. The examiner experience presented to be an important variable in the analysis.Keywords: Cleft palate; Speech intelligibility; Speech perception; Velopharyngeal insufficiency; Reconstructive surgical procedures RESUMO Objetivo: Verificar os resultados de inteligibilidade da fala de pacientes submetidos à palatoplastia primária, de acordo com o julgamento perceptivo de cinco examinadores, experientes ou não, no tratamento de fissuras labiopalatinas. Métodos: Foram analisados os registros de fala espontânea, armazenados em sistema audiovisual, de 78 pacientes com fissura labiopalatina previamente reparada, de ambos os gêneros, a partir de 4 anos de idade, submetidos à palatoplastia primária. As amostras de fala foram analisadas por cinco diferentes examinadores, que classificaram a inteligibilidade de fala utilizando uma escala de 3 pontos (1=boa, 2=regular e 3=ruim). A concordância interexaminadores foi verificada por meio do coeficiente de Kappa. O sucesso da reabilitação foi analisado descritivamente quanto às proporções de pacientes, de acordo com o grau de inteligibilidade pós-operatória, determinada pelos examinadores. A significância entre as diferenças das proporções obtidas para cada categoria foi verificada pelo teste Qui-quadrado (p<0,05). Resultados: A concordância entre os examinadores variou de discreta a substancial. Em mais da metade das amostras os examinadores obtiveram concordância plena. Com base nos valores médios dos julgamentos dos avaliadores, uma proporção significativa dos casos apresentou boa inteligibilidade de fala. Conclusão: Verificou-se adequação da inteligibilidade de fala após a ...

Speech Outcomes Audit for Unilateral Cleft lip and Palate After 2-Stage Palate Repair: Preliminary Results

“…Comparing these findings to previous studies with one-stage palate repair conducted at the same center, it is not possible to observe great differences in the various parameters considered for speech outcomes, as VPD rates were also variable, ranging from 14% to 37%. 19,20 As interfering factors, age at primary palate repair, surgical technique, and assessment criteria should be considered.…”