The Analysis Of Velopharyngeal Closure And Speech Intelligibility In Children With Cleft Palate Who Speak Guangxi Cuengh Language

Objective To evaluate the preoperative and postoperative speech intelligibility among 3～6 years old children with cleft palate who spoke Guangxi Cuengh language. and make a comparison of the velopharyngeal incompetence rate between postoperative 3 months and 6 months, which aims to illustrate the internal relationship of pathological acoustic features and velopharyngeal closure. Subsequently observe the improvement of velopharyngeal closure ability and speech intelligibility after operation, giving a specific speech-therapy further improves the comprehensive treatment for children with cleft palate.Methods 20 children’s basic data with cleft palate who spoke Zhuang Cuengh language were collected. Speech samples of preoperative and postoperative 3and6 months were recorded by digital voice recorder. The speech intelligibility of samples were evaluated by three professional speech and hearing therapist. Nasopharyngeal fiberscope was used to observe velopharyngeal closure ability of postoperative 3and6 months. Computer video was used to capture the velopharyngeal cavity picture while the children were pronuncing and resting, respectively. Velopharyngeal cavity area and the rate of velopharyngeal incompetence were calculated by software-Image-Pro■ Plus 6.0. Software spss16.0 was used to analysis data.Results When children with cleft palate pronounced/a/、/e/、/i/、/u/、/o/、 /w/, compared with 3th months, the rate of velopharyngeal incompetence in 6th months was obviously decreased(P<0.05), which indicated that velopharyngeal competence was significantly improved after voice training. Compared with preoperative speech intelligibility, the postoperative 3and6 months speech intelligibility was significantly increased(P<0.001). It was clearly visible that the correct rate and accuracy of pronunciation was 3-5 folds increased. If a continuing 3-6 months speech training and human intervention was implemented, children’s speech intelligibility would be further enhanced, still existed a hugely difference with normal person’s speech. There was no obvious difference of speech intelligibility between 3 and 6 months after operation(P=0.213>0.05). The listening consistency rates of preoperative, postoperative 3and6 months were 91.57%,88.63% and 90.77%, respectively. And Kappa value was more than 0.8. Results indicated that the listening consistency of speech and hearing therapist were highly reliable, which played a huge role in the researchs of velopharyngeal incompetence and speech intelligibility.Conclusion After the operation, children with cleft palate who spoke Zhuang Cuengh language, the autonomic activity of lateral pharyngeal wall, retropharyngeal wall, tongue and soft palate was improved when they speaking, which resulted in the improvement of evelopharyngeal closure. Especially, when they pronounced vowels or consonants, respiratory airflow was absolutely isolated between nose and mouth, which resulted in the enhancement of voice clarity, manifesting the reduced emerging frequency of nasal, plosive and slurred speech. The results could provide a reference for the clinical treatment by giving the effective speech therapy and rehabilitation training to children with cleft palate, The quality of Guangxi Zhuang language would be improved.