The Logopedic Evaluation of Adult Patients after Orthognathic Surgery

Abstract

Orthodontists correct dental malocclusion, but major facial skeleton deformations (skeletal malocclusion) are often subject to surgical correction. Several speech pathologies are associated with both of the occlusal anomalies mentioned above. The majority of articulation disorders and primary functions cannot be improved without skeletal correction. This study aimed to investigate the outcome of the multimodal and logopaedics treatment of Polish adults affected by skeletal malocclusion and speech-language pathology. A total of 37 adults affected by skeletal Class II and III malocclusion were included, along with the relationship between the malocclusion and speech deficiency (20 phonemes tested) in the subjects before and after surgical correction. The impact of surgery on pronunciation improvement and types of Polish phonemes most often misarticulated by Polish adults were also examined. Patients underwent combined treatment and received a full speech pathology examination. The treatment improved speech (p < 0.05), but the study did not prove that a specific surgery type was associated with pronunciation improvement. Some patients were provided with speech therapy during childhood, yet most had some minor difficulties with lip and tongue movements. Palatal, alveolar (p < 0.05), fricatives (p < 0.05), and labiodental consonant pronunciation (p < 0.05) improved. The surgical correction of malocclusion leads to better articulation of Polish consonants in adults and improves some primary functions.

Functional Outcomes with Facial Artery Musculo-Mucosal (FAMM) Flap and Dental Implants for Reconstruction of Floor of the Mouth and Tongue Defects in Oncologic Patients

“…The use of the FAMM flap is the ideal reconstructive technique for the reconstruction of medium-sized defects involving the floor of the mouth and up to one third of the ipsilateral tongue. Although it provides a limited width and requires a second-stage procedure in many patients, it offers many benefits: (1) it is a thin and pliable flap with a great arc of rotation and length; (2) it is a musculo-mucosal flap ideal for reconstruction of mucosal defects with the absence of hair; (3) it is a safe and reliable flap that withstands postoperative radiotherapy [1]; (4) it is easy to harvest; (5) it enables primary closure of the donor site under 3 cm; (6) it can be harvested simultaneously with neck dissection; (7) previous neck dissection and radiation therapy are not contraindications [11][12][13]; (8) it can be superiorly or inferiorly based depending on the defect to be reconstructed; (9) it can be used as a reconstructive technique simultaneously with immediate placement of osseointegrated implants for both aesthetic and functional rehabilitation. Common regional flaps such as supraclavicular, submental and pectoralis major flaps are other reconstructive techniques suitable for these defects.…”

“…An important topic to note would be the rehabilitation of speech articulation with a speech pathologist. Different studies have reported significant improvement in speech in different surgical specialties such as oral surgery and orthognathic surgery [7,8]. The interdisciplinarity of speech and its effectiveness in the treatment of oncologic patients require the cooperation of maxillofacial surgeons and speech pathologists to achieve the best possible result in terms of speech articulation.…”

“…Speech articulation was evaluated subjectively by the patient and the maxillofacial surgeon by comparing the preoperative and postoperative situation. Unlike studies performed for speech evaluation in adults in different areas of oral surgery and orthognathic surgery [7,8], in this study no speech evaluation was performed by a speech pathologist.…”

Speech Disorders in Dysgnathic Adult Patients in the Field of Severity of Primary Dysfunction

“…The research, in general, was about the relationship between malocclusion, speech and articulation disorders. Previous papers on the subject have published data on the impact of short frenulum on speech and logopaedic evaluation of adult patients after orthognathic surgery [10,11]. In the presented study, the materials and the method were extended and adjusted.…”

“…Lichnowska and Kozakiewicz [10,11] proved that abnormal functioning of the tongue caused by ankyloglossia affects speech in adult patients with skeletal deformities. Moreover, as mentioned above, the authors proved that in most cases, phonemes such as alveolar, dental and palatal are disturbed and such coincidence of malocclusion and speech disorders require surgical intervention to correct.…”