Semi-occluded Vocal Tract Exercise in Velopharyngeal Dysfunction in Patients With Cleft Palate

The study is an uncompared before-after clinical trial. All patients were submitted to videonasoendoscopy and had their vocal emissions recorded before and after the four weeks of speech therapy. These individuals were submitted to multidimensional evaluation comprised of analysis of images generated by specialized videonasoendoscopy software, analysis of speech emissions by perceptual-auditory evaluation and acoustic analysis, and vocal self-assessment.

• Group before-after (Behavioral): The group was submitted to four weeks of speech therapy intervention with Semiocluded vocal tract exercise. The 12 participants were evaluated before and after the intervention with a multidimensional evaluation comprised of analysis of images generated by specialized videonasoendoscopy software, analysis of speech emissions by perceptual-auditory evaluation and acoustic analysis, and vocal self-assessment.

Primary outcomes

• Analyze the effect of semi-occluded vocal tract exercise, with high resistance tube, on the velopharyngeal mechanism [one month]: Patients were submitted to evaluation of the VPS (velopharyngeal sphincter) region before and after the speech therapy. Patients were sitting in the examination chair, facing the examiner, throughout the entire procedure. The otorhinolaryngologist framed the image of the VPS and tried to maintain the optic fiber positioned at this site while those being evaluated performed selected sentences.

Secondary outcomes

• Changes on speech after semi-occluded vocal tract exercise in cleft palate. [one month]: To measure this outcome, samples of the participant's speech were recorded before and after the exercise with semi-occluded vocal tract (SOVTE). The vocal samples were randomly presented to three experients judges, voice specialists. They analyzed the samples and consensually completed the protocol of perceptual-auditory evaluation.

Sex: All, ages: 6 Years to any

Inclusion Criteria:

* Individuals with surgically repaired CLP (Cleft lip and palate), regardless of gender and regardless of the type of clef palate.
* The sample only included patients aged 6+ because this is the ideal age to be submitted to videonasoendoscopy.
* These patients attended four speech therapy sessions.
* All individuals agreed to participate in this research voluntarily.

Exclusion Criteria:

* Individuals with cleft lip and palate associated with genetic syndromes or other congenital malformation
* Individuals who proved unable to do SOVTE (Semi-occluded Vocal Tract Exercise),
* No condition to be submitted to videonasoendoscopy examination,
* Patients who did not attend the four sessions of therapy or who did not do exercise at home were excluded from the sample.

• Marcus Vinicius M Collares, MD, PhD, Study director, Chief of plastic surgery of Clinicas Hospital of Porto Alegre's