快速腭扩张器(RPE)通常用于唇腭裂(CLP)患者,然后再进行二次牙槽骨移植(SABG)。它们的位置和大小会阻碍舌头运动并影响言语。这项研究评估了RPE治疗过程中言语感知和产生的变化。
预期纵向。
大学附属医院。
25例单侧CLP患者接受Fan型RPE治疗,和他们的父母。
在插入RPE(T1)之前,在基线时收集患者和父母言语问卷和患者言语记录,直接在RPE插入后(T2),在RPE扩展(T3)期间,在RPE保留期间(T4),在去除RPE后但在SABG(T5)之前,以及去除RPE和SABG(T6)后的短期随访。
患者和家长问卷的评分,元音/a/的第一(F1)和第二(F2)共振峰,/i/,和/u/,以及非鼻句和鼻句的鼻音评分,获得并使用混合模型方差分析进行分析。
在T2时评级恶化。对于元音/a/,F1和F2在T2时没有变化。对于元音/i/,在T2时F1增加而F2减少。对于元音/u/,F1不变,F2在T2时降低。鼻音在T2时没有变化。到T4时,所有结果指标均恢复到T1水平。
插入RPE对言语感知和产生产生了最初的不利影响,在移除前降至基线。有关短暂性言语功能障碍和痛苦的信息可能有助于患者为治疗做好准备。
Rapid palatal expanders (RPEs) are commonly used in patients with cleft lip and palate (CLP) prior to secondary alveolar bone grafting (SABG). Their position and size can impede tongue movement and affect speech. This study assessed changes in perception and production of speech over the course of RPE treatment.
Prospective longitudinal.
Tertiary university-affiliated hospital.
Twenty-five patients with unilateral CLP treated with Fan-type RPEs, and their parents.
Patient and parent speech questionnaires and patient speech recordings were collected at baseline before RPE insertion (T1), directly after RPE insertion (T2), during RPE expansion (T3), during RPE retention (T4), directly after RPE removal but before SABG (T5), and at short-term follow-up after RPE removal and SABG (T6).
Ratings for patient and parent questionnaires, first (F1) and second (F2) formants for vowels /a/, /i/, and /u/, and nasalance scores for non-nasal and nasal sentences, were obtained and analyzed using mixed model analyses of variance.
Ratings worsened at T2. For the vowel /a/, F1 and F2 were unchanged at T2. For the vowel /i/, F1 increased and F2 decreased at T2. For the vowel /u/, F1 was unchanged and F2 decreased at T2. Nasalance was unchanged at T2. All outcome measures returned to T1 levels by T4.
RPE insertion resulted in initial adverse effects on speech perception and production, which decreased to baseline prior to removal. Information regarding transient speech dysfunction and distress may help prepare patients for treatment.