Immediate Acoustic and Glottographic Effects of Straw Phonation in Air and Water in Children with Repaired Cleft Palate.

OBJECTIVE

The objective of this study was to investigate the immediate acoustic and glottographic effects of straw phonation in air and water in children with repaired cleft palate.

STUDY

DESIGN

Quasi-experimental pre-post intervention.

METHODS

Sixteen children with repaired cleft palate and velopharyngeal dysfunction, along with 16 age- and gender-matched participants without a cleft palate, were investigated. All participants underwent two sequential training conditions: straw phonation in air (SPA) and straw phonation in water (SPW), with one end submerged 2 cm in water inside a 500 mL bottle filled to two-thirds capacity. A straw with a 5 mm inner diameter and 25.8 cm length was used. A 20-minute period vocal rest was observed between the two phonation conditions. Acoustic and glottographic assessments were conducted at three points: (1) pre-SPA, (2) post-SPA, and (3) post-SPW. Acoustic measures including jitter, shimmer, harmonics-to-noise ratio (HNR), cepstral peak prominence (CPP), acoustic voice quality index (AVQI), and acoustic breathiness index (ABI), along with electroglottography (closed quotient [CQ]), were evaluated before and immediately after each training condition.

RESULTS

Straw phonation in air and water produced immediate, parameter-specific improvements in acoustic measures (jitter, shimmer, HNR, CPP, AVQI, ABI) in children with and without repaired cleft palate, with no changes in fundamental frequency, indicating subtle short-term effects even in voices perceptually rated as normal.

CONCLUSIONS

SPW was more effective than SPA, producing greater improvements in acoustic parameters and CQ, particularly in children with cleft palate. Both methods yielded positive results, but SPW may be especially beneficial as part of therapeutic programs to prevent voice disorders in this population.