Aspectos da fala de indivíduos com fissura palatina e labial, corrigida em diferentes idades

Abstract

OBJETIVO: comparar indivíduos com fissura labiopalatina que realizaram correção cirúrgica em diferentes idades e verificar quais os fatores intervenientes mais importantes nas alterações da fala. MÉTODOS: a amostra é composta por 29 indivíduos que nasceram com fissura labiopalatina e foram submetidos à correção cirúrgica em diferentes idades, sem outros comprometimentos associados (neurológicos, físicos, psicológicos, etc). Estes indivíduos foram avaliados sem se levar em consideração a etiologia e o tipo de malformação encontrado. Sendo que 13 do sexo masculino e 16 do sexo feminino possuem idades variando de seis a 13 anos de idade. Os indivíduos são do ambulatório de Distúrbios da Comunicação Humana de uma Universidade Pública Federal e do ambulatório de Cirurgia Plástica de um Hospital Público que ainda não entraram em terapia fonoaudiológica. A fala, desses indivíduos, foi avaliada pelo Teste de Fonologia (capítulo 1 do ABFW, Teste de Linguagem Infantil), e por meio da nomeação foi analisada a fala dos indivíduos. A nomeação foi feita com figuras simples que foram mostradas a eles. RESULTADOS: os resultados do presente estudo quanto ao sexo e o tipo de fissura da amostra não apresentaram resultados estatisticamente significantes. Entretanto, a época tardia em que ocorreu a cirurgia reparadora interferiu de forma negativa para emissão de fala desses pacientes. CONCLUSÕES: com base nos resultados obtidos da análise da fala de indivíduos com fissura labiopalatina, pode-se concluir que um fator interveniente importante para a sua fala é a idade em que é realizada a cirurgia corretiva.

Perfil da fala de pacientes submetidos à palatoplastia primária

“…One of the main objectives of cleft palate repair is to establish adequate velopharyngeal function, so that communication development can occur as most appropriately as possible. The chances of adequate speech development decrease significantly when late repair occurs (5)(6)(7) . A previous study (6) reported statistically significant difference between early and late operated individuals with respect to presence of phonological processes, with these processes appearing less frequently in the group that underwent early surgery.…”

“…The chances of adequate speech development decrease significantly when late repair occurs (5)(6)(7) . A previous study (6) reported statistically significant difference between early and late operated individuals with respect to presence of phonological processes, with these processes appearing less frequently in the group that underwent early surgery. Failure in velopharyngeal closure, either due to the presence of cleft or velopharyngeal dysfunction, with respect to speech-related aspects, results in loss of part of the airway to the nasal cavity, leading to the appearance of symptoms that may directly or indirectly impair speech understandability (8) .…”

“…Failure in velopharyngeal closure, either due to the presence of cleft or velopharyngeal dysfunction, with respect to speech-related aspects, results in loss of part of the airway to the nasal cavity, leading to the appearance of symptoms that may directly or indirectly impair speech understandability (8) . Hypernasality, audible nasal air emission, and weak intraoral air pressure are considered direct or primary consequences of velopharyngeal closure failure (6,8) , whereas compensatory articulation disorders (CAD) -strategies used by individuals with the objective of compensating in other points of the vocal tract the inability to impose pressure to the oral cavity -are defined as indirect or secondary consequences (6,8) . During adequate functioning of the velopharyngeal mechanism, it is necessary that the soft palate and the posterior and lateral walls of the pharynx perform a wide and synchronized movement, allowing contact between these structures and ensuring total separation between the oral and nasal cavities during the production of oral sounds (9) .…”

“…The first year of a child is of fundamental importance for the acquisition of speech and language (10) . The specific scientific literature clearly reports that surgical repair of the cleft palate should be performed early, before two years of age (5,6,11) , especially when considering speech (5,12) . The surgical treatment aims to provide adequate velopharyngeal function, which is essential in early childhood (6) .…”

“…The specific scientific literature clearly reports that surgical repair of the cleft palate should be performed early, before two years of age (5,6,11) , especially when considering speech (5,12) . The surgical treatment aims to provide adequate velopharyngeal function, which is essential in early childhood (6) . To this end, different palatoplasty techniques have been developed over time aiming to achieve adequate palate length, in order to allow velopharyngeal closure.…”