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