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28 Cards in this Set
- Front
- Back
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cleft lip
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-opening in the lip, usually upper (lower rare), usually associated w/cleft of palate, usually unilateral on left side
- congenital -cleft lip alone rarely requires speech therapy |
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cleft palate
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-opening in hard palate, soft palate, or both
-congenital, may be due to genetic syndrome - embryonic period 7-10 wks of gestation most crucial period |
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cleft palate causes
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-gentic anamolies (syndromes, inheritance, chromosome abnormalities)
-enviornemntal (drugs, FAS, perscriptions, rubella) - mechanical (intrauterine crowding, twinning, uterine tumor, amniotic ruptures) - |
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classification of clefts
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-cleft lip
- cleft of alveolar process -cleft of prepalate - cleft of palate -cleft of prepalate and palate -facial celfts -microforms (submucous cleft) |
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submucous cleft
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- surfase tissues of soft or hard palate fuse,but underlying muscle or bone tissues do not
- SC of soft palate( bifid uvula) -SC of hard palate (bony defect in midline, notch) -causes hypernasal speech, ear infections - tx: surgery, prostetic device for velopharyngeal incompetence, therapy, combo |
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congenital palatopharyngeal incompetence
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-not a form of clefting
- impaired velopharyngeal closing-valve funtioning - laryngeal structures appear normal, but endoscopy reveals impairment -caused by short palate, submucous cleft, reduced mass o soft palate, deep larynx -hypernasal speech -speech therapy, surgery, prostheses, or combo |
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comm disorders associated with clefts
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-hearing loss
~prone to ear infections, eustachian tube dysfuntion -artic disorders ~more significant if palatal cleft not repaired early or inadaquately -difficulty with voiced, pressure consonants, audible nasal emission, vowel distortion -Language disorders ~delayed lang dev't, but may return to normal -children w/ syndromes may have more severe or lasting language probvlems -Laryngeal/phonatory disorders ~nodules, edema of vocal folds, hoarse, reduced intensity and pitch, hyper or hyponaslaity or combo |
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assessment of children w/clefts
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-standard procedures
-main concern to assess artic and velopharyngeal adequacy |
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velopharyngeal assessment
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-nasopharyngoscopy
-videofloursocopy -manometer -nasometer -orofacial exam |
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tx of children w/clefts
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-surgery
-artic tx -language tx -resonance tx |
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rules of 10's
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- cleft surgery wait for the child to be 10lbs, 10 weeks olds, and a hemoglobin of 10
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primary surgery of cleft
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-when clefts are closed
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secondary closure of clefts
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-after primary, approve appearance and functioning
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lip surgery
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-closes lip
-3 months or 10lbs |
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palatal surgery
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-closes clefts of palates
-9-24 mos |
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v-y retroposition
or Veau-Wardill-Kilner |
-repairs cleft of palate
-repostitions flaps, lengthens palate |
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Von lanenback surgical method
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- repairs cleft of palate
- uses flaps, but does not elongate palate |
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delayed hard palate closure
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- cleft of soft palate closed first hard closed later
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pharyngeal flap
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- secondary surgery procedure
-muscular flap cut from posterior pharyngeal wall, raised, and attached to velum -opeinings on either side of flap allow for nasal breathing, sound prodcutin, and drainage - flap helps closes velopharyngeal wall and reduces hypernasality |
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pharygoplasty
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-substance such as teflon/silicone/etc. are implanted or injected into the posterior pharyngeal wall to make it bulge and close velopharyngeal port.
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tx of artic for cleft patients
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- teach more visible sounds (except linguadentals), stops, and frics 1st
- k & g may be innapropriate if velopharygeal function is inadaquate -lingupalatals, lingualvelors, lingudentals taught in this order -compensatory artic positioning |
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tx for resonance disorders for cleft patients
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- hypernasality should not be treated until: surgery to improve physiological functioning & child is capable of velopharyngeal closure
-voice therapy techniques: increase loudness, discrim training,, lower pitch, increase mouth opening ) - biofeedback |
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angelman syndrome
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-no birth defects, chromosome 15
- dx between 3-7, delay is present since 6mos -symptoms: seizures, stiff gait, happy demeanor, excitable personality, hand flapping, short attention span -few or no words, recpetive and nonverbal skills better then expressive |
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apert syndrome
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-caused by spontaneous autosomal mutations
-syndactly (digital fusion), craniosynostosis (small skull), flat frontal & occipital bones, high forehead, midfacial hypoplasia(underdev't), arched/grooved hard palate, conductive HL, malocclusion III, cleft of hard palate -hyponsality, artic problems w/alveolars & labiodentals -normal intelligence or mild-mod intellectual disability |
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cri du chat syndrome
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-high pitched cry
-low set ears, narrow oral cavity, laryngeal hypoplasia, microcephaly, micrognathia, oral clefts -artic and lang disorders associated w/intelectual disability |
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crouzon syndrome
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- hypolpasia of midface/maxilla, craniosynostosis, small jaw, far apart eyes, facial assymetry, etc.
-conductive HL, artic dis, hyponaslaity, lang dis |
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down syndrome
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-extra chromosome 21
-hypotonia, flat face, small ears nose and chin - midface dysplasia, large tongue -conductive or sensorineural loss, hypernaslaity, nasal emission, breathy voice, artic dis |
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fragile x
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-long large poorly formed pinna, big jaw, high forehead, enlarged testes
- intellectual disability progressively gets worse -jargon, perseveration, echolalia, lack of gestures, voice and artic problems - hyperactive, autistic like social skills, socially withdraw -EI crucial |
