Endoscopic Procedure

Profiling endoscopic parameters, articulation errors and resonance disorders in clients with cleft lip and palate.

INTRODUCTION
Cleft lip and palate is one of the most commonly known etiological factors causing a significant impact on the speech and language development as well as the socio cultural aspects. The overall incidence of cleft lip and palate is found to be 1:600; with prevalence being 6.64 per 10,000 in India by Dwivedi and Dwivedi (2012). Nasoendoscopy is one of the objective measures to evaluate the functioning of the endoscopic structures like soft palate, lateral pharyngeal wall and posterior pharyngeal wall. In a study by Panaigua L.M, Signorini A.V. and Sylvia Dornelles (2012), an interdependent relationship between the velopharyngeal competence,

2) Levator veli palatini muscle: Adequate LVP movement in 59% and inadequate in 41%.
1) Closure: 71.8% had a central closure and 28% had a lateral closure. 28% of the cases had < 50% closure; 37.5% had 50-80% closure whereas 34% had > 80% closure.

B) Perceptual assessment of articulation errors and resonance problems
1) Articulation:; Fricatives are more afftected (65.63%) followed by affricates and stops; the most commonly seen error was distortions( 56.25%) followed by omissions and substitutions. Reduced intra oral pressure was seen in 90.63% of the cases. Amongst the stops more errors were observed on velars followed by palatals.
2) Nasal emission and turbulence: 63% and 40.63% of the cases had nasal emission and turbulence respectively.
3) Hypernasality: Moderate hypernasality present in 59.36%, severe in 15.63% and mild in 21.88% with a consistent 68.75%.
4) Overall velopharyngeal competency:
Incompetent: 45%; borderline to borderline competent: 42%;
Competent to borderline competent:10%; 3% were fully competent.
C) Unilateral CLP, bilateral CLP and cleft of hard palate