Chapter 14: Cleft Lip and Palate

• 1 in every 730 births in the world result in cleft deformity
• Teratogens: any substance, agent, or process that interferes with prenatal development causing abnormalities
• intraoral air pressure: buildup of air pressure in oral cavity that produces force needed for oral consonants
• Palatal (oronasal) fistula: congenital abnormal small hole or passageway in hard palate into the nasal cavity that allows intraoral air pressure and some sounds to enter nasal cavity that can cause nasal emission/nasalization.
• bifid uvula: divided uvula
• Hypernasal (hypernasality): resonance disorder that occurs when oral consonants and vowels enter nasal cavity due to cleft
• Velopharyngeal insufficiency (VPI): anatomical or structural defect that prevents adequate velophargyngeal closure, including a short velum
• Velopharyngeal Incompetence (VPI): neuromotor or physiological disorders that result in poor movement of velopharyngeal structures
• submucous cleft: defect in hard palate in absence of an actual opening into the nasal cavity or a defect in muscles of soft palate that cannot be seen through the mucosal tissue. resulting in velopharyngeal incompetence and hypernasality
• Velopharyngeal Dysfunction (VPD): condition where velopharyngeal valve does not close consistently during production of oral sounds
• Eustachian (auditory) tube: Tube lined w/ mucous membrane tissue that joins nasopharynx and middle ear cavity. Normally closed but opens during yawning, chewing & swallowing
• nasal (air) emission: abnormal flow of airstream through nose during production of consonants that require a buildup of intraoral air pressure
• Hyponasality (denasal, denasality): perceived sounds when there is complete blockage of the entrance to nasal passages and /m/, /n/, and /ng/ sounds are eliminated and sound more like /b/, /d/, /g/
• Glottal Stops: compensatory articulation productions primarily for plosive sounds (/b/ /p/ /t/ /d/) used by individuals with velopharyngeal incompetence. causes grunting sound
• Pharyngeal Fricatives: compensatory articulation productions primarily for fricatives and affricates and used by individuals with velopharyngeal incompetence. causes friction sound.
• Interdisciplinary (multidisciplinary) team: group of professionals from various disciplines who work together to coordinate care of a patient
• Minimum core professionals for cleft palate: surgeon, SLP, and orthodontist
• Rule of 10s: guideline for appropriate time for a cleft lip repair. infant must be 10 weeks of age, 10 lbs, and have hemoglobin count of 10 grams before repair.
• Palatine (faucial) tonsils: tonsils. bundles of lymphatic tissue located in lateral oropharynx. Important part of immune system.
• Orthognathic Surgery: surgery that involves the bones of the maxilla and mandible
• Nasopharyngoscopy: minimally invasive procedure commonly used by SLPs for evaluation of velopharyngeal dysfunction that allows visual observation and analysis of mechanism during speech using an endoscope
• videofluoroscopy: xray procedure used to examine deep structures of body during movement
• Prosthetic devices: for cleft palate, a device made of acrylic and metal, designed to close a cleft in the hard palate or the velopharyngeal port for speech
• palatal obturator: prosthetic appliance that can be used to cover an open palatal defect