| Clinically,we often find that the operation of repair the cleft palate is successful,but the final speech effect is not satisfactory, quite a few of patients speechintelligibility is still very poor. There are many reports on influence factors of speecheffect in patients after palatoplasty,and hearing is one of the factors that effect thespeech of cleft palate patients. Although some datas show that palatoplasty canimprove the velopharyngeal function, many postoperative patients pronunciationimprovement is not ideal, perhaps due to hearing impairment in some extent.Because of the anatomic features of oropharyngeal, cleft palate patients often existehearing impairment, and most children with cleft palate in infancy appear hearingimpairment, so it makes the children lose some information acceptance and decreasespeech discrimination, then it is bound to affect the function of language. There isimportant clinical significance that exporation the influence of hearing loss in speecheffects.Part I Characteristics of Hearing Loss in Cleft Palate Patientsafter PalatoplastyObjective：To explorate the rate of hearing loss, the factors affecting hearing loss, andthe characteristics of hearing loss in different frequencies in patients after cleft palateoperation, and to provide a basis for further study. Methods：50subjects with repaired cleft palate and36subjects with unrepaired cleftpalate were recruited to conduct a pure tone assessment binaurally. We observedhearing loss incidence and hearing levels, and analysised of the patients’ gender, age,cleft type, operation age, recovery time, with and without cleft lip, right and left earsand other factors, also compared hearing threshold of100ears of50subjects withrepaired cleft palate in different frequencies.Results：Hearing loss were found in14subjects (28.00%) of50subjects withrepaired cleft palate, and15subjects (41.67%) of36subjects with unrepaired cleftpalate.84.21%of abnormal ears in subjects with repaired cleft palate had mildandmoderate hearing loss. For the36postoperative patients with normal hearingability, hearing loss was identified on the frequency of250Hz,500Hz and6k Hz(36.11%,16.67%and11.11%) respectively. Gender, cleft type, operation age, withand without cleft lip and right and left ears groups had no significant difference in theincidence of hearing loss in cleft palate, while age, recovery time and postoperativepatients with normal hearing in different frequencies groups had significantdifference.Conclusion：Characteristics of hearing loss in cleft palate patients after palatoplasty:（1）The rate of hearing loss in cleft palate patients after palatoplasty is much lowerthan that patients before palatoplasty.（2）Part of the patients with repaired cleft palate still have different degrees ofhearing loss, and hearing loss is mainly mild and moderate. With hearing loss severitygrowing, the rate of hearing loss is lower, and hearing loss of severe and very severealmost is none.（3）Male and female patients with repaired cleft palate has no significant differencein the incidence of hearing loss.（4）The rate of hearing loss in less than12years patients with repaired cleft palate is significantly higher than that in subjects older than12years.（5）Hard/Soft cleft palate and complete cleft palate patients hearing loss rate have nosignificant difference.（6）With repaired cleft palate before2years old and after2years old have nosignificant difference in the incidence of hearing loss.（7）Recovery time less than5years patients are with a higher incidence of hearingloss than recovery time more than5years.（8）Cleft palate patients with cleft lip have no increase in the incidence of hearingloss.（9）Bilateral complete cleft palate and incomplete cleft palate patients have nosignificant difference in the incidence of hearing loss, and unilateral complete cleftpalate fractured and unfractured ears hearing loss rate have no significant difference.（10）Mild hearing loss in low-frequency region and high-frequency are also reportedon normal hearing patients.Part II Study Hearing Loss on the Effect of Cleft PalateSpeech in Chinese MandarinObjective：To investigate the effect of hearing to cleft palate patients in ChineseMandarin.Methods：30subjects of cleft palate were examined for hearing and evaluated speech,together counted error frequency and type of consonant. According to the Chinesetone frequency and intensity distribution and measurement table of dysarthria inMandarin, hearing and speech were divided to three levels respectively. We usedSpearman rank correlation analysis, looking for whether Chinese Mandarin wasrelated to hearing. Results：Hearing examination results: Different degrees of hearing loss were found in12subjects(40.00%) of30subjects with repaired cleft palate, which9subjects withmonaural hearing loss and3subjects with binaural hearing loss. Binaural ears of18subjects (60.00%) were normal hearing. Speech evaluation results:22subjects(74.33%) of30subjects with repaired cleft palate speech effects were excellent andgood, others (26.67%) speech effects were medium and poor.6subjects(50.00%) of12subjects with hearing loss speech effects were medium and poor, but only2subjects (11.11%) of18subjects without hearing loss were medium and poor.6subjects (75.00%) of8subjects with medium and poor speech effects had hearingloss, but only6subjects (27.27%) of22subjects with excellent and good speecheffects had hearing loss. Higher error frequency consonants (form high to low) were[t],[ts],[k],[],[s],[t] and [k‘]. The types of error were mainly omittion andsubstitution. There was significant difference (P<0.05) between consonants andhearing including [t],[t‘],[k],[k‘],[t],[t ‘],[],[ts],[ts‘],[s],[t],[t ‘],[] and [],while the left consonants that [b],[m],[f] and [n]showed no significant differencewith hearing.Conclusion：Hearing quality in cleft palate patients have a direct impact on speechfunction recovery, so the effect of hearing loss on speech recovery in cleft palatepatients can not be ignored. The hearing loss of cleft palate patients mainly affect thehigh-frequency consonants that pronunciate in the back region of the oral cavity,which are mainly omittion and substitution with high-frequency and low-thresholdtones. The hearing loss of cleft palate patients is not big to the influence of low andintermediate frequency consonants that pronunciate in the front region of the oralcavity. |
PDF Full Text Request