The purpose of this study was to investigate whether the timing of pressure-flow waveforms during speech was an important component in discriminating which patients received surgical referral from a cleft palate team for velopharyngeal insufficiency (VPI) and which patients did not.
This was a descriptive within group retrospective study comparing among 11 measures (8 temporal, 3 non-temporal) of velopharyngeal function to determine which measures most efficiently discriminated between patients who received surgical referral from a cleft palate team and those who did not.
Subjects were 75 children (5 to 18 years of age, 49 males) with repaired cleft palate seen for a team evaluation between 2001 and 2010 to determine whether or not a secondary surgery would be recommended. Forty-six of the 75 were referred for a secondary VPI surgery by the cleft palate team.
Results revealed nasal airflow first derivative to be the only statistically significant temporal measure; however, sensitivity and specificity calculations suggested it was not efficient at discriminating subjects for surgical referral. The three non-temporal measures (nasalance, velopharyngeal orifice area, and perceptual rating) were found to be statistically significant for discriminating surgical referral. These findings were supported by sensitivity and specificity calculations. Finally, age and gender effects were explored with a two-way analysis of variance (ANOVA) with 3 levels of age and 2 levels of gender. No effects of age or gender were evidenced.
The timing of pressure-flow waveforms during speech was not found to be an important component in discriminating patients for surgical referral. Results provided strong support for the use of the three non-temporal measures during the speech assessment of patients with cleft palate to help make decisions regarding referral for VPI surgery.
|Commitee:||Kelly, Donna, Smith, Bonnie, Smith-Olinde, Laura, Zraick, Richard|
|School:||University of Arkansas for Medical Sciences|
|Department:||Communication Sciences and Disorders|
|School Location:||United States -- Arkansas|
|Source:||DAI-B 73/10(E), Dissertation Abstracts International|
|Keywords:||Air pressure, Airflow, Resonance disorders, Speech stimuli, Velopharyngeal insufficiency surgery|
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