Abstract
This study investigatedt he presence and pattern of artic ulation disorders, velopharyngeal insufficienc(yV PI), fistulas, a nd abnormalitieso f occlusiona nd dental arch in 221 cleft p alate children who received the primary palatoplasty under the age of one and a half years. These factors were also analyzed focusing on the effect on palatalized articulation and lateral articulation. All subjects had been systematically treated by the Showa University Cleft Palate Team since 1980.
Data was obtained in the follow-up sessions, which were periodically provided, until the the subjects became five years old. No speech therapy was given before data collection. The results are summarized as follows:
1. Of 2 2 1 children,101 (46 %) showed articulation disorders.
2. Thirty-three subjects had mild VPI and two s u bjects demonstrated moderate to severe VPI. Twenty-six of them (74 %) showed artioulation disorders, and glottal stop was the most common type of their misarticulations.
3. One hun dred and eighty-six subjects (84 %) attained good velophpryngeal function although 75 of them (40 %) showed articulation disorders. Many of these subjects demonstrated palatalized articulation (60%) and lateral articulation (33%).
4. Types of clefts seemed to affect the patterns of misarticulations. Palatalized articulation frequently occurred in children with bilateral cleft lip and palate, while lateral artioulation frequently occurred in children with unilateral cleft lip and palate.
5. Fistulas were observed in 85 su bjects (38 %). Size of the fistulas appeared to affect the patterns of their misarticulations. In the subjects with larger fistulas, palatalized articulation was most common (50 %).
6. Occlusions were examined by the cast models in 124 cases. Eighty-seven of them (70 %) had cross bites with both front teeth and molar and palatalized articulation (45 %) was more frequently seen in these children than lateral articulation (15 %).
7. Severe constricted dental arches were found i n 32 of the 124 cases (26 %) and palatalized articulation (63 %) was more common than lateral articulation (19 %).
The results indicated that primary etiological factor of the articulation disorders in the cleft palate children was VPI and there was a tendency for the children with competent velopharyngeal function to show palatalized articulation caused by the effect of maxillary deformity.
