• 말소리와 음성과학
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• 제6권2호
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• pp.65-71
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• 2014

The purpose of this study was to investigate whether young children with cleft palate differ from those of noncleft typically developing children in terms of expressive vocabulary size, phonological characteristics and lexical selectivity. A total of 12 children with cleft palate and 12 noncleft children who were matched by age and gender participated in the study. The groups were compared by size of expressive vocabulary reported on Korean version of MacArthur-Bates Communicative Development Inventories and the number of different words, consonant inventory, the percentage of words beginning with obstruents and vowels, nasal, and glottal sounds, and the percentage of words which do not include obstruents in a language sample. Also, correlation analysis were performed to examine the relationship between measures on size of expressive vocabulary and phonological characteristics. The results showed that expressive vocabulary size and consonant inventory for children with cleft palate produced significantly smaller than those for noncleft children. Children with cleft palate produced significantly more words beginning with vowel or which do not include obstruents, and fewer words beginning with obstruents than noncleft children. The two groups showed different results on significant correlations between measures on size of expressive vocabulary and phonological characteristics indicating that children with cleft palate show different lexical selectivity from their noncleft peers. The results suggest that children with cleft palate aged 18-30 months demonstrate a slower rate of lexical and phonological development compared with their noncleft peers and they develop lexical selectivity reflecting cleft palate speech. The results will have a clinical implication on speech-language intervention for young children with cleft palates.

• 대한구순구개열학회지
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• 제11권2호
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• pp.59-63
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• 2008

Craniofacial Centre at Children's Hospital Boston is a worldwide leader in the care of children and adolescents with craniofacial anomalies especially with cleft lip and/or cleft palate, which provides a team approach to the evaluation, diagnosis and treatment of children and adults with congenital (present at birth) or acquired facial deformities. This is staffed by an experienced team of clinicians, such as in oral and maxillofacial surgery, plastic surgery, neurosurgery, dentistry, audiology, speech and language pathology, genetics, psychiatry, otolaryngology, and social work, all with specialized training in the care of children with craniofacial anomalies. Here, there is a short introduction of history, attending surgeons, works, and sequential treatment for cleft lip/palate patients about this institution.

• 치과방사선
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• 제23권1호
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• pp.103-114
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• 1993

The purpose of this study was to determine whether any difference existed in craniofacial morphology between parents of children with cleft lip and/or palate and parents of children without cleft lip and/or palate as well as the characteristics of craniofacial morphology in parents of children with cleft lip and/or palate. Thirty three measurements of the various regions of cranium and face were obtained from lateral cephalometric radiograms in parents of 28 children with cleft lip and palate, 18 children with cleft lip, and 22 children with cleft palate. There were 28 couples and 40 single parents in this sample. There were 92 individuals including 41 males and 51 females. The measurements were compared with those in control subjects, including 40 adult males and 40 adult females, who had no history of craniofacial abnormalities. The total sample was compared for the sex independently. The obtained results were as follows. 1. In the cranium, both parents of cleft children had significantly shorter posterior cranial base length(S-Ba). 2. In the upper face, a significantly shorter anteroposterior length of maxilla(A'-Ptm'), particularly in the anterior region (A'-K), anterior facial depth(A-SBaL), posterior facia! height(Ptm'-SNL) and relation of subnasale to the cranial base (∠BaN'Sn) were noted in fathers of cleft children. But, all measurements were not found to be significantly different between experimental group and control group in all mothers. 3. In the lower face, both parents of cleft children showed a significantly greater Y axis angle(∠NSGn) and ramal plane angle(∠SNL-RP) in fathers of cleft children. Thus both patents showed a posteriorly rotation of mandible. The thickness of the lower lip(B-B') was significantly thicker in fathers of cleft children. 4. In the facial profile, a significantly shorter posterior facial height(S-Go) and greater angle of soft tissue facial convexity (∠BaN'Pog') were noted in the fathers of cleft children. But, all measurements were not found to be significantly different between experimental group and control group in all mothers.

• 한국콘텐츠학회논문지
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• 제10권5호
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• pp.285-295
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• 2010

소음에너지가 시작되는 주파수 즉, 선행 모음이 끝나는 지점을 절삭주파수라 한다. 본 연구는 구개파열아동과 정상 아동을 대상으로 마찰음과 파찰음의 절삭주파수 값, 후행모음에 따른 절삭주파수 값, 절삭주파수와 비음 치의 상관관계를 알아보고자 하였다. 연구의 대상은 서울 및 경기 지역에 거주하고 있는 아동으로 구개파열 진단을 받고, 생활연령이 6세 이상인 아동, 생활연령과 성별을 일치시킨 6세 이상 정상아동 각각 6명씩 총 12명이었다. 실험과제는 마찰음 및 파찰음의 무의미음절 환경과 문장 환경(50환경)으로 구성하였다. 구개파열 아동 집단은 정상 아동 집단에 비해 마찰음, 파찰음의 절삭주파수 값이 무의미음절 환경 및 문장 환경 모두에서 낮게 나타났다. 구개파열 아동과 정상 아동의 절삭주파수와 비음치 간 상관관계 연구 결과 정상 아동 집단에서는 무의미음절 환경과 문장 환경 모두에서 통계적으로 유의한 상관관계를 보이지 않았으나 구개파열 아동 집단에서는 문장 환경에서 통계적으로 유의한 상관관계를 보였다.

• 대한구순구개열학회지
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• 제10권2호
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• pp.89-96
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• 2007

Otitis media with effusion is known to be very common among children with cleft palate and is the common cause of acquired hearing loss in childhood. The purpose of the present study was to examine the anatomic variances, incidence and treatment of middle ear disease in children with cleft palate. In Korea, before 4-year-old age, the prevalence of otitis media was as high as 91.7%. Common treatments for otitis media were conservative or surgical treatment. The medical treatment options include the use of decongestants, antihistamines, antibiotics and mucolytics. Surgical treatment options include grommet insertion, myringotomy. Unlike the case for children without clefts, cleft patient has a higher incidence of recurrence, so surgical treatment between the age of 3 month and 6 month was recommended. The effect of palatoplasty on middle ear disease has remained controversial. Early and periodic evaluation on the symptomatic infection or significant of hearing loss was recommended.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.80-86
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• 2024

Background Among the cleft types, bilateral cleft lip and palate (BCLP) generally requires multiple surgical procedures and extended speech therapy to achieve normal speech development. This study aimed to describe speech outcomes in 5-year-old Korean children with BCLP and examine whether normal speech could be achieved before starting school. Methods The retrospective study analyzed 52 children with complete BCLP who underwent primary palatal surgery at a tertiary medical center. Three speech-language pathologists made perceptual judgments on recordings from a speech follow-up assessment of 5-year-old children. They assessed the children's speech in terms of articulation, speech intelligibility, resonance, and voice using the Cleft Audit Protocol for Speech-Augmented-Korean Modification. Results The results indicated that at the age of five, 65 to 70% of children with BCLP presented articulation and resonance within normal or acceptable ranges. Further, seven children with BCLP (13.5%) needed both additional speech therapy and palatal surgery for persistent velopharyngeal insufficiency and speech problems even at the age of five. Conclusion This study confirmed that routine follow-up speech assessments are essential as a substantial number of children with BCLP require secondary surgical procedures and extended speech therapy to achieve normal speech development.

• 음성과학
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• 제8권3호
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• pp.185-200
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• 2001

This study was designed to investigate the treatment, generalization, and maintenance effects of vocal relaxation treatment on compensatory articulation(i.e., glottalization of plosive sound) of three children with cleft palate. Multiple baseline design was applied to evaluate treatment, generalization, and maintenance effects. The targeted phonemes were ph/, th/, /t/ which Were frequently substituted by glottal stop sounds. The main component of the treatment program was vocal relaxation using humming and aspiration sound /h/. The following conclusions were deduced from the results: (1) the treatment program for compensatory articulation was effective in facilitating correct production of targeted phoneme and eliminating glottalization for all subjects, (2) the treatment effects on articulation accuracy were generalized to untreated phonemes (/c/, /c$c^{h}$/) for 2 subjects, (3) the treatment effects on decrease of glottalization were generalized to untreated phonemes for all subjects, and (4) the treatment effects were maintained for all subjects for 2 weeks after treatment was terminated.

• The Korean Journal of Pain
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• 제33권1호
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• pp.81-89
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• 2020

Background: For children with cleft palates, surgeries at a young age are necessary to reduce feeding or phonation difficulties and reduce complications, especially respiratory tract infections and frequent sinusitis. We hypothesized that dexmedetomidine might prolong the postoperative analgesic duration when added to bupivacaine during nerve blocks. Methods: Eighty patients of 1-5 years old were arbitrarily assigned to two equal groups (forty patients each) to receive bilateral suprazygomatic maxillary nerve blocks. Group A received bilateral 0.2 mL/kg bupivacaine (0.125%; maximum volume 4 mL/side). Group B received bilateral 0.2 mL/kg bupivacaine (0.125%) + 0.5 ㎍/kg dexmedetomidine (maximum volume 4 mL/side). Results: The modified children's hospital of Eastern Ontario pain scale score was significantly lower in group B children after 8 hours of follow-up postoperatively (P < 0.001). Mean values of heart rate and blood pressure were significantly different between the groups, with lower mean values in group B (P < 0.001). Median time to the first analgesic demand in group A children was 10 hours (range 8-12 hr), and no patients needed analgesia in group B. The sedation score assessment was higher in children given dexmedetomidine (P = 0.03) during the first postoperative 30 minutes. Better parent satisfaction scores (5-point Likert scale) were recorded in group B and without serious adverse effects. Conclusions: Addition of dexmedetomidine 0.5 ㎍/kg to bupivacaine 0.125% has accentuated the analgesic efficacy of bilateral suprazygomatic maxillary nerve block in children undergoing primary cleft palate repair with less postoperative supplemental analgesia or untoward effects.

• 치과방사선
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• 제25권2호
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• pp.459-470
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• 1995

The purpose of this study was to determine whether any difference existed in craniofacial morphology between cleft children and normal subjects. Thirty three measurements of the various regions of cranium and face were obtained from lateral cephalometric radiograms in 40 cleft children(27 males, 13 females) and 40 normal subjects(23 males, 17 females) in our dental hospital from Jan. 1988 to Dec. 1995.The measurements were compared with those in control subjects who had no history of craniofacial abnormalities. The obtained results were as follows: 1. In the cranium, the cleft children had singificantly shorter posterior cranial base length(S-Ba) and total antero-posterior cranial base length(N-Ba) (P<0.05). 2. In the upper face, the cleft children had significantly shorter upper anterior facial height(N-ANS) and upper posterior facial height(Ptm'-SNL) (P<0.05). 3. In the lower face, the cleft children had significantly shorter antero-posterior mandibular length(Pog-Ar) and antero-posterior mandibular body length(Pog-Go) (P<0.05). 4. In the facial profile, the cleft children had significantly shorter total facial height(N-Me} and posterior facial height(S-Go) (P<0.05).

• Archives of Plastic Surgery
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• 제34권6호
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• pp.748-752
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• 2007

Purpose: The goal of palatoplasty is focused on two points. One is to close the palatal defect completely, and the other to create a velopharyngeal system for normal speech. While established methods such as pushback palatoplasty or double opposing Z palatoplasty are used in wide cleft palate repair, sequelae such as maxillary hypoplasia or oronasal fistula may result. Therefore, when palatoplasty with buccinator myomucosal flap is used in the case of wide cleft palates, maxillary hypoplasia and oronasal fistula is reduced and optimal results are obtained. Methods: From October 2005 to December 2006, four children with wide complete cleft palate underwent unilateral buccinator myomucosal flap and intravelar veloplaty. Mean age at cleft repair was 15 months, and mean cleft size was 2.15 cm. The patients underwent intravelar veloplasty and palatoplasty was done using unilateral buccinator myomucosal flap. Results: The patients, after mean 10 months of follow-up observation, showed no signs of oronasal fistula resulting from flap tension. The shape and color similar to normal oral mucosa was obtained, and velopharyngeal function was acquired. Conclusion: When intravelar veloplasty and palatoplasty with unilateral buccinator myomucosal flap is done on wide cleft palates, postoperative speech function is optimal, velopharyngeal incompetence is effectively corrected, and sequelae resulting from pushback palatoplasty and double opposing Z-plasty, such as maxillary hypoplasia and oronasal fistula, is reduced.