Craniofacial morphology and velopharyngeal physiology in four syndromes of clefting.
Item
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Title
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Craniofacial morphology and velopharyngeal physiology in four syndromes of clefting.
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Identifier
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AAI9207075
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identifier
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9207075
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Creator
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Golding-Kushner, Karen J.
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Contributor
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Adviser: Katherine Harris
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Date
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1991
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Language
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English
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Publisher
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City University of New York.
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Subject
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Health Sciences, Speech Pathology | Health Sciences, Medicine and Surgery
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Abstract
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Sources of heterogeneity within the population of individuals with cleft palate might predispose certain patients to a particular speech outcome regardless of surgical technique or age at the time of primary palatoplasty. Identification of possible sources of heterogeneity may provide guidance for the nature and timing of treatment and in expectations regarding palate repair. One possible source of variability in the speech production of subjects with cleft palate is skeletal morphology. Subjects with four syndromes associated with cleft palate, Stickler syndrome (S), Treacher Collins syndrome (TC), velo-cardio-facial syndrome (VCF), and van der Woude syndrome (VDW), were included in this study to examine the possibility that velopharyngeal function in subjects with clefts is related to differences in underlying cranial morphology and resultant vocal tract shape.;The goals of this study were to identify the prevalence of speech abnormalities in a large series of individuals with cleft palate and these four syndromes, and to examine the craniofacial and vocal tract morphology and velopharyngeal function was in a portion of the same sample. Measurements were made from lateral cephalometric tracings, nasopharyngoscopic and multi-view videofluoroscopic examinations.;Craniofacial morphology was largely syndrome specific and was correlated with vocal tract size and configuration. These characteristics were, in turn, related to differences in velopharyngeal closure patterns, but were not the sole determinants of velopharyngeal insufficiency (VPI). There was a difference in the prevalence and severity of VPI, resonance disorders, and compensatory speech disorders in different syndromes. In general, VPI was more prevalent in the presence of an obtuse cranial base angle and wide pharynx than in a narrow pharynx associated with kyphosis of the cranial base.;Craniofacial morphology and vocal tract configuration were most abnormal in Treacher Collins syndrome. Although subjects with TC had the lowest prevalence and severity of VPI, their patterns of velopharyngeal and lingual movements were most abnormal. Severe hypernasality and compensatory speech disorders were most prevalent in VCF and subjects with VCF who have submucous cleft palate seem to be at a higher risk for speech and resonance abnormalities than subjects with the other three syndromes because of a combination of structural and, possibly, neurologic abnormalities.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
