Speech outcome in children with cleft palate: aerophonoscope assessment of nasal emission.

The quality of speech is an important outcome measure of the success of primary surgery for clefts of the palate. A competent velopharyngeal mechanism is essential for normal speech, and disorders of resonance and nasal airflow are significant manifestations of velopharyngeal dysfunction in cleft palate subjects. The aim of this study was to determine the level of nasal emission during speech in patients with functionally repaired clefts of the palate and compare this with age and sex-matched controls. Forty-four children between the ages of 3 and 9 years were assessed for nasal emission using an Aerophonoscope. All these patients had primary functional surgery carried out at this unit by the same surgeon, and fell into three groups; complete bilateral, complete unilateral and soft palate clefts. Nasal breathing, blowing and groups of vowels and voiceless pressure consonants were assessed. There was no nasal emission in close to, or over, 90% of the patients for these parameters. The results indicate that a highly significant percentage of children with functionally repaired clefts of the palate have normal velopharyngeal function and speech, without inappropriate nasal emission. The Aerophonoscope provides an accurate, reliable and user-friendly diagnostic aid, and indeed therapeutic adjunct, to speech management in cleft palate patients.