Current Practice in Assessing and Reporting Speech Outcomes of Cleft Palate and Velopharyngeal Surgery: A Survey of Cleft Palate/Craniofacial Professionals

Abstract

This survey shows considerable variability in the methods for evaluating and reporting speech outcomes following surgery. There is inconsistency in what is considered a successful surgical outcome, making comparison studies impossible. Most respondents thought that success should be defined as normal speech, but this is not happening in current practice.

Nasoendoscopic findings after primary palatal surgery: can the Furlow technique result in a smaller velopharyngeal gap?

“…The ability of the surgeon to conduct the surgical technique has been cited as an important factor in the outcome of the treatment of cleft lip and palate (6)(7)(8)(9)(10)(11) . The surgeons involved in this study were using the vL procedure as the routine surgical technique for primary repair of cleft lip and palate while they were trained to perform the F technique for the study.…”

“…However, this proportion may increase considerably when the patients undergo surgery late in their lives, or when the choice of surgical technique did not consider circumstances relevant to speech (3,9,10) .…”

“…However, it is very common that this assessment be complemented with instrumental techniques, especially nasoendoscopy and videofluoroscopy (4,18) . Nasoendoscopy, specifically, is a technique that allows direct visualization of velopharyngeal structures and their movements during speech (4,9) . It complements the clinical evaluation and allows the team to define the best approach to be used.…”

Influência do uso de amostras de referência no julgamento perceptivo-auditivo da oclusiva glotal

“…Estudos (PAMPLONA et al, 2012;BESSELL et al, 2013) Apesar de existirem métodos objetivos para a avaliação da fala como a avaliação aerodinâmica e análise acústica o julgamento perceptivo-auditivo é o método de avaliação considerado como "padrão ouro" para a caracterização das alterações de fala (GERRATT et al, 1993;KREIMAN et al, 1993;KENT, 1996;KUEHN;MOLLER, 2000;KUMMER et al, 2012;CHAPMAN et al, 2015). A avaliação perceptiva das alterações de fala, incluindo as AC, pode sofrer influência de vários fatores (SANTELMAN; SUSSMAN; CHAPMAN, 1999;GOOCH et al, 2001;HOWARD;HESELWOOD, 2002;HENNINGSSON et al, 2008), dentre estes destacam-se a experiência do avaliador em realizar o julgamento perceptivo-auditivo destas produções (GOOCH et al, 2001;OLSSON, 2004;BRUNNEGARD;LOHMANDER, 2007), bem como a seleção e qualidade das amostras de fala utilizadas durante o julgamento.…”

Função velofaríngea após cirurgia de retalho faríngeo: influência do tipo de fissura labiopalatina

“…Kummer et al (2012), em levantamento sobre a prática clínica atual em avaliação dos resultados de fala na fissura palatina, verificaram que a avaliação perceptiva é o método prevalente (99,2%) entre os profissionais da área, seguido de exame intraoral (96,8%), nasofaringoscopia (59,3%), nasometria (28,9%), videofluoroscopia (19,2%) e medidas aerodinâmicas (4,3%).…”