Cleft Palate & Craniofacial Anomalies: Effects on Speech and Resonance, Second Edition

Cover
......Page 1
Title Page
......Page 3
Copyright
......Page 4
Dedication......Page 5
Contents......Page 6
Legends for Videos......Page 9
Preface......Page 25
About the Author......Page 32
Contributors......Page 34
Part 1: Normal and Abnormal
Craniofacial Features......Page 37
Ch 1: Anatomy and Physiology: The Orofacial Structures and Velopharyngeal Valve
......Page 38
Anatomy of the Orofacial Structures......Page 39
Anatomy of the Velopharyngeal
Mechanism......Page 49
Physiological Subsystems for Speech......Page 53
Physiology of the Velopharyngeal Valve......Page 56
Variations in Velopharyngeal Closure......Page 60
Changes in Velopharyngeal Function with Growth and Age......Page 64
For Review, Discussion, and Critical Thinking......Page 66
References......Page 67
Ch 2:
Clefts of the Lip and Palate......Page 72
What Is a Cleft?......Page 73
Causes of Clefts and Basic Classification......Page 74
Clefts of the Primary Palate (Lip and Alveolus)......Page 78
Clefts of the Secondary Palate (Hard Palate and Velum)......Page 83
Submucous Cleft Palate......Page 87
Facial Clefts......Page 93
References......Page 96
Ch 3:
Genetics and Patterns of Inheritance......Page 101
Deoxyribonucleic Acid (DNA) and Genes......Page 102
Chromosomes......Page 105
Mendelian Inheritance......Page 110
Non-Mendelian Inheritance......Page 115
Summary......Page 118
References......Page 119
Ch 4:
The Genetics Evaluation and Common Craniofacial Syndromes......Page 122
The Genetics Evaluation......Page 123
Dysmorphology......Page 128
Genetics of Cleft Lip (with or without Cleft Palate)......Page 129
Syndromes Associated with Cleft Lip (with or without Cleft Palate)......Page 131
Sequence and Syndromes Associated with Cleft Palate......Page 134
Genetics of Craniosynostosis......Page 140
Craniosynostosis Syndromes......Page 141
Miscellaneous Syndromes......Page 145
References......Page 149
Part 2: Problems Associated with Clefts and Craniofacial Anomalies......Page 155
Ch 5: Feeding Problems of Infants with Cleft Lip/Palate or Craniofacial Anomalies......Page 156
Normal Anatomy and Physiology of Infant Feeding......Page 158
Craniofacial Anomalies and Pediatric Dysphagia......Page 162
General Feeding Modifications......Page 165
Specific Feeding Considerations and Techniques......Page 171
Key Oral-Motor Facilitation Techniques......Page 174
Feeding the Older Infant......Page 179
Objective Studies for Assessment of Airway Protection during Feeding......Page 180
Management of Severe Cases......Page 181
References......Page 182
Appendix 5-1:
General Feeding Tips for Parents......Page 186
Appendix 5–2: Feeding Infants with Clefts Using Adapted Nipples and Bottles......Page 188
Ch 6: Developmental Aspects: Language, Cognition, and Phonology......Page 190
Factors That Can Affect Development......Page 191
Development of Children with Clefts and Craniofacial Syndromes......Page 196
Summary......Page 199
References......Page 200
Appendix 6–1: Language Stimulation Information
for Parents......Page 208
Ch 7: Resonance Disorders and Velopharyngeal
Dysfunction (VPD)......Page 212
Normal Resonance and Velopharyngeal Function......Page 213
Resonance Disorders and Velopharyngeal Dysfunction......Page 214
Other Effects of Velopharyngeal Dysfunction on Speech......Page 219
Factors That Impact Speech Characteristics and Severity......Page 227
Causes of Velopharyngeal Dysfunction......Page 230
Summary......Page 240
References......Page 241
Ch 8: Ear, Nose, and Throat Anomalies: Effects on Speech and Resonance......Page 250
The Ear......Page 251
The Nose......Page 257
The Oral Cavity......Page 259
Causes of Upper Airway Obstruction......Page 263
Treatment of Upper Airway Obstruction......Page 265
References......Page 269
Ch 9: Dental Anomalies Associated with Cleft Lip/Palate: Effects on Speech......Page 274
Normal Dentition......Page 275
Dental Anomalies and Speech......Page 279
Dental Development and Stages of Cleft Treatment......Page 288
The Role of Speech Therapy......Page 304
For Review, Discussion, and Critical Thinking......Page 305
References......Page 306
Ch 10: Psychosocial Aspects of Cleft Lip/Palate and Craniofacial Anomalies......Page 315
Family Issues......Page 316
School Issues......Page 319
Societal Issues......Page 324
Summary......Page 327
References......Page 328
Part 3:
Interdisciplinary Care......Page 333
Ch 11: The Team Approach to Assessment and Treatment......Page 334
Need for Team Management......Page 335
Characteristics of Teams......Page 336
Advantages of and Potential Problems with the Team Approach......Page 344
Challenges to the Specialty Team Concept......Page 347
For Review, Discussion, and Critical Thinking......Page 348
References......Page 349
Part 4: Assessment Procedures: Speech, Resonance, and Velopharyngeal Dysfunction
......Page 353
Ch 12: Assessment Using "Low-Tech" and "No-Tech" Procedures......Page 354
Direct versus Indirect Measures for Evaluation......Page 355
Timetable for Assessment......Page 356
The Diagnostic Interview......Page 357
Language Screening......Page 360
Speech Samples......Page 362
What to Evaluate......Page 364
Simple "Low-Tech" and "No-Tech" Evaluation Procedures......Page 368
Follow-Up......Page 376
References......Page 378
Appendix 12–1: The Effects of Cleft Lip/Palate on Communication Development: Information for Parents......Page 382
Summary......Page 384
Ch 13: Orofacial Examination......Page 385
General Methodology......Page 387
Important Observations......Page 389
Infection Control During the Examination......Page 405
Summary......Page 408
References......Page 409
Ch 14:
Nasometry......Page 412
Nasometry and Its Clinical Uses......Page 413
Equipment......Page 415
Nasometric Procedures......Page 416
Nasometric Results......Page 428
Interpretation of Nasometric Results......Page 431
Use in Treatment......Page 435
Summary......Page 438
References......Page 439
Appendix 14–1: Standard Nasometric Passages Supplied by KayPENTAX......Page 444
Appendix 14–2: Score Sheet for the SNAP Test-Revised......Page 446
Ch 15: Speech Aerodynamics......Page 451
Why Aerodynamic Assessment?......Page 452
Basic Principles of the Pressure-Flow Technique......Page 453
Instrumentation and Calibration......Page 457
Assessment of the Nasal Airway......Page 460
Speech Aerodynamics and Velopharyngeal Function......Page 465
References......Page 479
Endnotes......Page 481
Ch 16: Videofluoroscopy and Other Forms of Radiography......Page 482
Radiography/Imaging......Page 484
Videofluoroscopy Procedure......Page 486
Interpretation......Page 492
Reporting the Results......Page 496
Advantages and Limitations of Videofluoroscopy......Page 497
References......Page 499
Ch 17:
Nasopharyngoscopy......Page 503
Endoscopy......Page 504
Nasopharyngoscopy Preparation......Page 509
Nasopharyngoscopy Procedure......Page 513
Interpretation......Page 518
Cleaning and Storing the Endoscope......Page 531
Advantages and Limitations of Nasopharyngoscopy......Page 532
Summary......Page 533
References......Page 534
Appendix 17–1......Page 541
Part 5: Treatment Procedures: Speech, Resonance, and Velopharyngeal Dysfunction......Page 543
Ch 18: Surgical Management of Clefts and Velopharyngeal Dysfunction......Page 544
Cleft Lip Repair......Page 545
Cleft Palate Repair: Palatoplasty......Page 552
Surgery for Velopharyngeal Insufficiency/Incompetence (VPI)......Page 558
For Review, Discussion, and Critical Thinking......Page 568
References......Page 569
Ch 19: Orthognathic Surgery for Craniofacial Differences......Page 577
Alveolar Bone Grafting......Page 578
Maxillary Advancement......Page 580
Mandibular Reconstruction......Page 587
For Review, Discussion, and Critical Thinking......Page 591
References......Page 592
Ch 20:
Prosthetic Management......Page 595
Prosthetic Devices......Page 596
Speech Appliances......Page 600
Clinical Indications and Contraindications for Prosthetic Management......Page 608
Prosthetic Management and Speech Therapy......Page 609
For Review, Discussion, and Critical Thinking......Page 610
References......Page 611
Ch 21:
Speech Therapy: Making It Simple!......Page 616
Timetable for Intervention and Goals......Page 617
Appropriate Candidates for Speech Therapy......Page 619
Speech Therapy Techniques......Page 620
Biofeedback Techniques Using Instrumentation......Page 631
Other Special Procedures......Page 633
Carry-Over......Page 635
For Review, Discussion, and Critical Thinking......Page 636
References......Page 637
Appendix 21–1: Speech Stimulation Information
for Parents......Page 643
Ch 22: Cleft Lip/Palate Missions to
Developing Countries......Page 645
Cleft Palate Missions......Page 646
Preparing to Go......Page 649
The Speech-Language Pathologist on a Mission Team......Page 651
For Review, Discussion, and Critical Thinking......Page 659
References......Page 660
Appendix A: Resources for Parent Information and Support......Page 662
Appendix B: Cleft Palate Foundation Publications......Page 666
Glossary......Page 668
Index......Page 698