Can Peripheral Hearing Justify the Speech Disorders in Children with Operated Cleft Palate?

Introduction: Any impairment in the hearing ability of a child with cleft lip and palate may cause difficulties in receptive and expressive language. Purpose: Check the association between velopharyngeal dysfunction (VPD), compensatory articulation (CA), and peripheral hearing loss in children with cleft palate surgery. Methods: Retrospective study with 60 children (group 1: presence of VPD and CA; group 2: absence of VPD, presence of CA; group 3: presence of VDP, absence of CA; group 4: absence of VPD and CA), age 4 to 5 years old, with cleft palate surgery, through the analysis of the hearing, VP, and speech evaluations. Results  Group 4 presented 80% normal hearing; group 1 had 60% hearing loss. The conductive hearing loss type was the most frequent. The glottal stop was the most frequent in group 1 and the middorsum palatal plosive in group 2. There was no significant association (p = 0.05) between hearing loss and the presence of compensatory articulations (groups 2 and 4), nor between hearing loss and the presence of VPD (groups 3 and 4; p = 0.12). Statistical significance (p = 0.025) was found when the group with VPD was associated with the group with CA, that is, group 1 with the control group (group 4). Conclusion:  Significant association between peripheral hearing loss, compensatory articulations, and VPD was verified for the children in group 1, which not only presented compensatory articulations but also VPD...

Can peripheral hearing justify the speech disorders in children with operated cleft palate?

Introduction Any impairment in the hearing ability of a child with cleft lip and palate may cause difficulties in receptive and expressive language. Purpose Check the association between velopharyngeal dysfunction (VPD), compensatory articulation (CA), and peripheral hearing loss in children with cleft palate surgery. Methods Retrospective study with 60 children (group 1: presence of VPD and CA; group 2: absence of VPD, presence of CA; group 3: presence of VDP, absence of CA; group 4: absence of VPD and CA), age 4 to 5 years old, with cleft palate surgery, through the analysis of the hearing, VP, and speech evaluations. Results Group 4 presented 80% normal hearing; group 1 had 60% hearing loss. The conductive hearing loss type was the most frequent. The glottal stop was the most frequent in group 1 and the middorsum palatal plosive in group 2. There was no significant association (p = 0.05) between hearing loss and the presence of compensatory articulations (groups 2 and 4), nor between hearing loss and the presence of VPD (groups 3 and 4; p = 0.12). Statistical significance (p = 0.025) was found when the group with VPD was associated with the group with CA, that is, group 1 with the control group (group 4). Conclusion Significant association between peripheral hearing loss, compensatory articulations, and VPD was verified for the children in group 1, which not only presented compensatory articulations but also VPD.

Auditory complaints and audiologic assessment in children with surgically repaired cleft lip and palate

INTRODUCTION: At the initial consultation, the speech-language pathologist and audiologist may consider possible diagnostic hypotheses based on the child's history and the parents' complaint. AIM:To investigate the association of hearing complaints with the findings obtained in the conventional audiologic assessment in children with cleft lip and palate. Retrospective study. METHODS: We analyzed medical charts of 1000 patients with cleft lip and palate who underwent surgical repair between 1988 and 1995 at a mean age of 6 years 8 months. We excluded charts with records of inconsistent audiological responses and charts with missing data for any of the audiologic evaluations considered. Thus, the sample consisted of 393 records. RESULTS: Two hundred thirty-nine patients presented hearing loss in one or both ears, but only 3.8% reported hearing complaints. The most frequent were otorrhea followed by otalgia. There was no statistical significance between the complaint and gender (p = 0.26) nor between the complaint and hearing loss (p = 0.83). CONCLUSION: This study showed no association between the hearing complaint and the conventional audiologic assessment.

Auditory complaints and audiologic assessment in children with surgically repaired cleft lip and palate.

INTRODUCTION: At the initial consultation, the speech-language pathologist and audiologist may consider possible diagnostic hypotheses based on the child's history and the parents' complaint. AIM: To investigate the association of hearing complaints with the findings obtained in the conventional audiologic assessment in children with cleft lip and palate. Retrospective study. METHODS: We analyzed medical charts of 1000 patients with cleft lip and palate who underwent surgical repair between 1988 and 1995 at a mean age of 6 years 8 months. We excluded charts with records of inconsistent audiological responses and charts with missing data for any of the audiologic evaluations considered. Thus, the sample consisted of 393 records. RESULTS: Two hundred thirty-nine patients presented hearing loss in one or both ears, but only 3.8% reported hearing complaints. The most frequent were otorrhea followed by otalgia. There was no statistical significance between the complaint and gender (p = 0.26) nor between the complaint and hearing loss (p = 0.83). CONCLUSION: This study showed no association between the hearing complaint and the conventional audiologic assessment.

Timpanometria em lactentes utilizando sonda multifrequencial / Multifrequency tympanometry in infants

Introdução: O uso de uma única frequência na timpanometria não é sensível na detecção de todos os casos de alteração na orelha média, dificultando o diagnóstico preciso. Objetivo: Caracterização das medidas de imitância acústica de lactentes utilizando três tipos de sonda. Estudo prospectivo. Método: Foram avaliados 54 lactentes, com idade entre zero e três meses. Os critérios de inclusão foram ausência de infecções de vias aéreas, presença de emissões otoacústicas evocadas transientes, ausência de indicadores de risco para perda auditiva. Foi realizada entrevista audiológica, inspeção visual do meato acústico externo e medidas de imitância acústica nas frequências de 226Hz, 678Hz e 1000Hz. Foram coletados os registros timpanométricos de efeito de oclusão, curva e pressão de pico timpanométrico, volume equivalente do meato acústico externo e pico compensado da admitância acústica estática. Resultados: Os resultados indicaram presença de efeito de oclusão (2,88% em 226Hz, 4,81% em 678Hz e 3,85% em 1000Hz); predomínio de curva em pico único (65,35% em 226Hz, 81,82% em 678Hz e 77,00% em 1000Hz); pressão de pico variando de -150 a 180daPa; aumento do volume equivalente do meato acústico externo com aumento da frequência da sonda (0,64ml em 226Hz, 1,63mmho em 678Hz e 2,59mmho em 1000Hz); aumento do pico compensado da admitância acústica estática (0,51ml em 226Hz, 0,55mmho em 678Hz e 1,20mmho em 1000Hz). Foram classificados como normais 93,06% dos timpanogramas com 226Hz, 80,81% em 678Hz e 82,00% em 1000Hz. Conclusão: Por meio destas avaliações e resultados foi possível caracterizar as medidas de imitância acústica dos lactentes...

Introduction: The use of conventional tympanometry is not sufficiently sensitive to detect all cases of middle ear changes, and this hinders accurate diagnosis. Objective: To characterize acoustic immittance measures of infants from 0 to 3 months of age using multifrequency tympanometry in a prospective study. Method: 54 infants from 0 to 3 months of age were evaluated. The inclusion criteria included absence of respiratory infections during the evaluation, presence of transient evoked otoacoustic emissions, and absence of risk indicators for hearing loss. The subjects were evaluated by an audiologic interview, a visual inspection of the ear canal, and measures of acoustic immittance at the frequencies of 226 Hz, 678 Hz, and 1,000 Hz. Tympanometric records of the occlusion effect, tympanometric curve type, tympanometric peak pressure, equivalent ear canal volume, and peak compensated static acoustic admittance were collected. Results: The results indicated the presence of an occlusion effect (2.88% at 226 Hz, 4.81% at 678 Hz and 3.85% at 1,000 Hz), predominance of a tympanometric curve with a single peak (65.35% at 226 Hz, 81.82% at 678 Hz, and 77.00% at 1,000 Hz), and tympanometric peak pressure ranging from -155 to 180 daPa. Further, the equivalent ear canal volume increased with the frequency of the probe (0.64 mL at 226 Hz, 1.63 mho at 678 Hz, and 2.59 mmho at 1,000 Hz) and the peak compensated static acoustic admittance values increased with an increase in frequency (0.51 mL at 226 Hz, 0.55 mmho at 678 Hz and 1.20 mmho at 1,000 Hz). 93.06% of the tympanograms were classified as normal at 226 Hz, 81.82% at 678 Hz, and 77.00 % at 1,000 Hz, respectively. Conclusion: Taken together, these results demonstrated that utilizing these evaluations made it possible to characterize the acoustic immittance measures of infants...

Multifrequency tympanometry in infants.

INTRODUCTION: The use of conventional tympanometry is not sufficiently sensitive to detect all cases of middle ear changes, and this hinders accurate diagnosis. OBJECTIVE: To characterize acoustic immittance measures of infants from 0 to 3 months of age using multifrequency tympanometry in a prospective study. METHOD: 54 infants from 0 to 3 months of age were evaluated. The inclusion criteria included absence of respiratory infections during the evaluation, presence of transient evoked otoacoustic emissions, and absence of risk indicators for hearing loss. The subjects were evaluated by an audiologic interview, a visual inspection of the ear canal, and measures of acoustic immittance at the frequencies of 226 Hz, 678 Hz, and 1,000 Hz. Tympanometric records of the occlusion effect, tympanometric curve type, tympanometric peak pressure, equivalent ear canal volume, and peak compensated static acoustic admittance were collected. RESULTS: The results indicated the presence of an occlusion effect (2.88% at 226 Hz, 4.81% at 678 Hz and 3.85% at 1,000 Hz), predominance of a tympanometric curve with a single peak (65.35% at 226 Hz, 81.82% at 678 Hz, and 77.00% at 1,000 Hz), and tympanometric peak pressure ranging from -155 to 180 daPa. Further, the equivalent ear canal volume increased with the frequency of the probe (0.64 mL at 226 Hz, 1.63 mho at 678 Hz, and 2.59 mmho at 1,000 Hz) and the peak compensated static acoustic admittance values increased with an increase in frequency (0.51 mL at 226 Hz, 0.55 mmho at 678 Hz and 1.20 mmho at 1,000 Hz). 93.06% of the tympanograms were classified as normal at 226 Hz, 81.82% at 678 Hz, and 77.00 % at 1,000 Hz, respectively. CONCLUSION: Taken together, these results demonstrated that utilizing these evaluations made it possible to characterize the acoustic immittance measures of infants.

Prótese de palato em sujeitos com disfunção velofaríngea: expectativas e ansiedade / Palatal prosthesis in subjects with velopharyngeal dysfunction: expectations and anxiety

Considerando que fissura labiopalatina é uma anomalia importante em nossarealidade clínica, que os procedimentos cirúrgicos têm como objetivo restaurar a forma ea função normal das estruturas alteradas, e que muitas vezes sujeitos com esse tipo demalformação por motivos variados não podem se beneficiar dessa forma de tratamento,sendo indicados outros procedimentos, como, a utilização de Prótese de Palato (PP), opresente estudo tem como objetivo mensurar a gravidade dos sintomas de ansiedade everificar a expectativa de sujeitos com disfunção velofaríngea (DVF), indicados à colocaçãoda PP. São analisados 30 sujeitos do Hospital de Reabilitação de Anomalias Craniofaciaisda USP com DVF, de ambos os gêneros, na faixa etária de 15 a 64 anos, com idademédia de 28 anos. Como instrumentos de natureza psicológica, são utilizados umquestionário de expectativa formulado pela primeira pesquisadora e o Inventário deAnsiedade de Beck. Ocorre expectativa com relação à modificação da fala em todos ossujeitos referente à: mudança nos aspectos profissional e afetivo, que é a mais relatada;idade e gênero não são fatores relevantes nos níveis de ansiedade; o nível mínimo deansiedade é o de maior ocorrência, sendo que a expectativa aparece com menor frequênciaque a ansiedade(AU)

Cleft lip and palate (CLL) is a very common craniofacial anomaly. The cleft isusually corrected with surgery which may fail resulting in velopharyngeal dysfunction (VPD).The use of palatal prosthesis is an alternative treatment for correcting both, CLP andVPD. This study evaluated anxiety symptoms expectations of subjects of both genders,with velopharyngeal dysfunction, referred to palatal prosthesis program for VPD treatment.In this cross sectional and descriptive study 30 subjects with velopharyngeal dysfunction,aged 15 to 64 years old (mean age of 28) were interviewed at the Hospital for Rehabilitationof Craniofacial Anomalies (HRAC). All subjects referred to the palatal prosthesis programat HRAC in the year of 2005 were considered for participation in the study but only the first30 candidates were included. A questionnaire addressing expectation elaborated by theresearcher and the Beck Scale on anxiety were used. All subjects showed expectationregarding speech modification. Changes in professional and affective aspects of theirlives after changes in speech were obtained with palatal prosthesis were the most reportedexpectations. Subjects’ age and gender influenced anxiety levels significantly which wereminimum across subjects. High levels of expectation were more frequent than anxiety inthe sample population(AU)