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Surgical maxillary advancement and speech resonance: comparison among cleft types

Avanço cirúrgico de maxila e ressonância de fala: comparação entre os tipos de fissura

Maria Natália Leite de Medeiros-Santana; Bruna Mara Adorno Marmontel Araújo; Ana Paula Fukushiro; Inge Elly Kiemle Trindade; Renata Paciello Yamashita

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Purpose: This study investigated the influence of the cleft type on the appearance of hypernasality after surgical maxillary advancement (MA). Methods: Nasality was determined by measurement of nasalance (acoustic correlate of nasality) by nasometry. The study involved analysis of the nasalance scores of 17 individuals with isolated cleft palate (CP), 118 with unilateral cleft lip and palate (UCLP) and 69 with bilateral cleft lip and palate (BCLP), of both sexes, aged 18 to 28 years, after MA. Only individuals with normal nasalance scores indicating balanced resonance before MA were included in this study. Nasometry was performed 3 days before and 15 months after MA, on average. The proportion of patients who presented nasalance scores indicating hypernasality after surgery was calculated by the ANOVA test, and comparison among the different cleft types was evaluated by the chi-square test (p < 0.05). Results: No significant difference was found in the proportions of individuals with hypernasality among the cleft types. Conclusion: Nasometry showed that the appearance of hypernasality after MA in individuals with cleft palate with or without cleft lip occurred in similar proportions, regardless of the cleft type.


Cleft Palate; Orthognathic Surgery; Velopharyngeal Insufficiency; Speech; Speech Disorders


Objetivo: Investigar a influência do tipo de fissura sobre o aparecimento da hipernasalidade após o avanço cirúrgico da maxila (AM). Método: A nasalidade foi determinada por meio da medida de nasalância (correlato acústico da nasalidade) utilizando-se a nasometria. Foi realizada a análise dos escores de nasalância de 17 indivíduos com fissura isolada de palato (FP), 118 com fissura de lábio e palato unilateral (FLPU) e 69 com fissura de lábio e palato bilateral (FLPB), de ambos os sexos, com idades entre 18 e 28 anos, submetidos ao AM. Apenas indivíduos com escores de nasalância indicativos de ressonância equilibrada previamente ao AM foram incluídos neste estudo. A nasometria foi realizada, em média, três dias antes e 15 meses após o AM. A proporção de pacientes que apresentaram escores de nasalância indicativos de hipernasalidade após o AM foi calculada por meio do teste ANOVA e a comparação entre os diferentes tipos de fissura foi realizada utilizando-se o teste Qui-quadrado (p < 0,05). Resultados: Não foi observada diferença significante entre as proporções de indivíduos com hipernasalidade, de acordo com o tipo de fissura. Conclusão: A nasometria mostrou que o aparecimento da hipernasalidade após o AM, em indivíduos com fissura de palato envolvendo ou não o lábio, ocorreu em proporções similares independentemente do tipo de fissura


Fissura Palatina; Cirurgia Ortognática; Insuficiência Velofaríngea; Fala; Distúrbios da Fala


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