CLEFT PALATE FINAL

What are the 7 cosmetic goals of primary surgery on the primary palate?

When is surgery for the primary surgery of primary palate timed?

What is the "Rule of 10s?"

What's the rationale for doing the primary surgery early?

What's the rationale for doing primary surgery later?

What are 4 primary surgeries of the primary palate?

What primary surgery of the primary palate is reserved for minimal clefts and is a straight line procedure?

The drawbacks of this surgery are that it sacrifices too much tissue (short lip) and that it destroys cupid's bow?

What primary surgery of the primary palate is reserved for more extensive clefts (prime)?

The advantages of this surgery are that it wastes little tissue, produces full lip, and has a natural cupid's bow.

The disadvantage of this surgery is that it creates an elongated lip on cleft side.

What primary surgery of the primary palate does the scar line up along the philtral ridge from the base of columella?

The advantages of this surgery are flexible lips and procedure, and easier revision.

What primary surgery of the primary palate creates 2 raw surfaces on each side of the cleft for better preliminary alignment prior to a later definitive lip repair?

What are the goals of the primary surgery of the secondary palate?

How is success measured for a functional velar mechanism?

What's the rationale for secondary palate surgery done early?

What's the rationale for secondary palate surgery done later?

What are 7 subgoals of secondary palate surgery?

When is the primary surgery of the secondary palate timed?

What are the 2 most common primary surgeries of the secondary palate?

Which primary surgery of the secondary palate makes lateral incision along alveolar ridges, edges are pared, creates 2 bi-pedicled flaps,and tissue freed up so it can be slid toward midline and sutured to close cleft? It also leaves denuded bone where incisions made that will later fill with granulation tissue forming a scar that appears white.

The advantages of this surgery are that it emphasizes preservation of blood supply and growth retardation prevented by mucosa being sutured off?

The disadvantage of this surgery is limited length of velum.

Which primary surgery of the secondary palate is more common in the U.K. and prepares 2 uni-pedicled flaps leaving denuded bone?

The advantage to this surgery is that there's more potential for greater length of velum.

What's the primary veloplasty surgery?

Which surgery's goal is to recreate the levator sling by closing soft palate at early age and waits to repair hard palate until adolescence while pt wears a prosthetic device in hard palate to inhibit growth retardation of the maxillo-facial complex?

What are 2 supplemental procedures to augment primary procedures in order to provide a better foundation?

Supplemental palatoplasty surgery that uses the mucoperiosteal tissue of the vomer to cover a unilateral or bilateral cleft palate. This procedure can be used to reconstruct the nasal or oral surfaces by either raising the vomer or creating a flap. Drawbridge closes the gap

Oral-Nasal Fistula can occur if this supplemental procedure is not done; soft tissue breaks down and hole results. Borrowing site usually from rip or hip.

What's the goal of secondary procedures of the secondary palate?

What secondary procedure of the secondary palate creates a flap of muscle tissue bulge into the posterior pharyngeal wall in the hope that the bulge will become dynamic (like manmade Passavant's pad)?

What secondary procedure of the secondary palate implants some kind of inert/stable substance that won't do anything but will create a bulge that will hopefully make the distancein closing the gap. Silicon, teflon, collagen, and cartilage have been used for this.

What are the problems that can occur with pharyngeal implants?

What is the most common secondary procedure of the secondary palate?

What's the biggest drawback of the early versions of pharyngeal flaps?

Most common pharyngeal flap where base is above the flap itself. If there's active muscle tissue it will elevate velum.

Pharyngeal flap where base is below the flap itself. Does not aid in velar closure but will aid in lateral wall movement.

When will a pharyngeal flap surgery be done?

What's the best prosthesis for pts whom the soft palate is mobile but too short to adquately close the VP port completely? Provides surface for pharyngeal walls to squeeze against providing VP valving. May provide replacements for teeth.

Why are 4 reasons prosthetics may be used?

What type of prosthetic is used when velum is intact but has inadequate movement. This device lifts velum into a position so that when it moves it will come into contact with pharyngeal wall. Velum crutch.

What are the advantages of using cephalometerics?

What are the disadvantages of using cephalometrics?

X-ray slices may detect what the masking of basic radiograph didn't but still requires static speech.

What are the advantages of using videofluoroscopy?

What are the disadvantages of using videofluoroscopy?

What's the name of the original oral parendoscope that was not useful because of rigidity pts couldn't talk, gag, and burnt from hot light bulb?

What are the advantages of using fiberoptic endoscopy?

What are the disadvantages of using oral fiberoptic endoscopy?

What's the disadvantage of using nasal fiberoptic endoscopy?

What instrument measures the amount of intraoral air pressure that can be exerted/generated by an individual and is no longer used?

What instrument uses a coil with an arrow attached sealed in a case to measure unit of intraoral air pressure by a person blowing through a tube, air compresses coil and the attached arrow moves to point to the numeric unit of air pressure? (An average of 3 measurements each w/ nares open/closed)

If person had a VPI, would they be most successful with nares open or closed when using oral manometer?

What's the advantages of using an oral manometer?

What are the disadvantages of using an oral manometer?

What's the best instrumentation to detect VPI by translating fluctuations of air pressure into elecrical signals?

What instrument has one tube go in the mouth for oral pressure and two in the nose one with a nasal olive that measures nasal pressure during nasal sounds and another that is directed into a heated flowmeter that detects nasal emissions that cool a wire to increase electrical signal.

The pressure flow technique correlates measures of what?

If there's a big VPI leak, it'll take __________ to get nasal emission.

What are the advantages of using Pressure Flow Technique?

What are the disadvantages of using Pressure Flow Technique?

VPI rating of less than 5mm²

VPI rating of less than 5-10 mm²

VPI rating of 10-20 mm²

VPI rating of greater than 5-10 mm²

This instrument measures resonance imbalance through acoustic energy by monitoring VP behavior during speech using microphones on a plate under nose, signals fed to computer creates a ratio of nasal acoustic energy divided by nasal acoustic energy plus oral acoustic energy.

Resonance which is the percent of all acoustic energy that is emanating through the nasal cavity.

What are the advantages of using a nasometer?

What are the disadvantages of using a nasometer?

What type of articulation errors are common in preschool?

What type of articulation errors are common in school-age?

What type of articulation errors are common in adolescence/adults?

List the most to least difficult manner of production for speakers with cleft palate.

What's the most difficult place of articulation for speakers with cleft palate?

In what sounds is the glottis closed half the time so air pressure drops making them less difficult?

Regarding context, __________ are more difficult than single phonemes.

Better speech is associated with earlier surgery, what would be the main reason surgery was delayed?

What type of cleft will individuals most likely have better speech?

If person that has cleft has nasal obstruction, why will their speech sound better?

Why does dentition/occlusion not affect speech much?

Consistency is the _________ of specific consonant productions and the consistency of those productions.

What is the most typical specific articualtion error in cleft palate speakers?

What test is used to evaluate phonetic context and tests consistency of phonemes production?

Which instrumentation/procedure is best for measuring airflow (nasal emission)?

NE/s

Squiggly above /s/ with two dots

Double tildy above /s/

Tildy with line through it

Nasal emission ________ is the best/direct/physical evidence of a leak.

Compensatory substitution that is done to build up pressure right below port so won't have to rely on velum ("bottle"; "Lawton")

Glottal stop but moving the point of restriction up against posterior pharyngeal wall.

Compensatory strategy that presses tongue to back of pharynx; pressure is below velum (cough up hairball sound)

Compensatory substitution sounds like a "German /r/" or "Arabic" sound. (Curvy X)

Compensation by valving with the nares; this is a learned behavior won't go away just because cleft is repaired.

What's the typical voice quality of cleft palate speakers?

Often cleft palate speakers exhibit ________ pitch in their voice.

Hypernasality deals with __________ not airflow.

Explain cul-de-sac resonance.

How does having cleft palate possibly affect language?

It all depends on how the child was raised...

What evaluation test focuses on * items (sibilants, fricatives...high pressure consonants); could do same thing with picking these out on the Goldman Fristoe.

What tests for error patterns and is organized in columns with headings such as nasal emission, velar fricative, nares constriction, pharyngeal fricative)?

This test is not particularly useful because cleft speech errors are in articulation not phonological (linguistic).

In this test the child says a word such as "beat" over and over with and without nares closed.

What's the treatment or nasal emission that is consistent?

This program affects hypernasality: syllable combinations starting with low oral impedance and then move up the hierarchy to plosives.

Cleft speech management is based on successive _________.

What are 4 steps to establish correct articulatory placement in response to compensatory errors?

Oral calisthenics/blowing exercises are supposed to help with nasal emission but doesn't really. How can it be used?

What are 3 forms of biofeedback discussed in class?

Biofeedback technique using fiberoptic technology so that they can learn to control muscles when they see the effects visually on monitor.

Using this biofeedback device with plate and 2 microphones games can be played. (Birdie in the sky)

This biofeedback tool has a clear vertical tube with a thinner flexible tube that goes in nose. If the plug goes up and down it's an "oops" if it doesn't move, they've got it. Helps post flap surgery to teach them how to use it.

What are 10 people that may serve on a cleft palate team?

What are the advantages of a cleft palate team?

What's a disadvantage of a cleft palate team?

What are 5 roles of the SLP?