Yarık Damaklı Çocuklarda Konuşma Özelliklerinin Ses Üzerine Etkisinin İncelenmesi
Abstract
It is generally accepted that children with cleft palate are at high risk for having a
voice disorder. It is thought that there is a clear relationship between velopharyngeal
insuffiency and voice disorders. It is hypothesised that one of the most common
cause of this relationship is the laringeal compensation mechanism characterized by
glottal stops. This mechanism is one of the compensation strategy of the person
develops by self to compensate for velopharyngeal insufficiency. It is characterized
by an abrupt and forced adduction of vocal folds. These errors can persist and
become an phonological error pattern although palate is repaired. Searching the
relation between velopharyngeal function and voice disorder doesn’t account for this
mechanism. So that, the main purpose of our study is to search the effect of speech
characteristics on voice in children with cleft palate. In this study I. Group consisted
of 40 children who didn’t have glottal stop productions in their speech, II. Group
consisted of 20 children who had glottal stop productions in their speech. Two
groups’ voice characteristics were compared by perceptual analysis (GRBAS),
pediatric voice handicap index , acoustic analysis, videolaryngoscopy; both groups’
velopharyngeal function was determined by flexible fiberoptic endoscopy and
nasometer evaluations. Pediatric voice handicap scores were higher in II. Group.
(p<0,05). Jitter, Shimmer and SPI values were found numerically higher in II. Group
in both age ranges; 4-6 and 7-12. There wasn’t significant difference detected
between two group with regard to G, R, B parameters. There wasn’t difference
detected in terms of vocal fold pathology frequency in videolaryngoscopy between
two group. When relationship searched between velopharyngeal closure and voice
disorder in all group, there was significant difference found when comparing voice
disorder frequency in complete closure with respect to incomplete closure or
borderline closure. It is thought that there is a relation between velopharyngeal
function and voice disorder. The possible factors may be the other compensatory
articulation products in addition to glottal stops. Also, in our study 90 children with
cleft palate were evaluated by videolaringoscopy to get the voice disorder
prevalance. It was found that %22,2 of children had vocal pathologies on
videolaringoscopy. It is thought that this value is higher than the healthy population