Question

Articulation case study:

Sam, now a 6 year old male was recently adopted from Vietnam. He was born with a bilateral complete cleft lip and palate. The cleft lip was repaired in Vietnam, but the cleft palate was left unrepaired. Due to the cleft palate, he has velopharyngeal dysfunction i.e. his velum does not retract and meet the posterior pharyngeal wall to close off the nasal cavity.

1. Which anatomical structures are missing/affected in a complete bilateral cleft palate?

2. Which anatomical structures are missing/affected in a complete bilateral cleft lip?

3. How do you think Sam sounds i.e. what is his vocal quality? Why? Hint: Think about how the velopharyngeal insufficiency is affecting his overall articulation.

4. Despite his velopharyngeal insufficiency, there are certain phonemes of the English language that he can produce effectively. What are those phonemes?

5. What affects might Sam’s cleft palate have on swallowing? (2) Please answer all 5 questions

Answer 1

1. in complete cleft lip both right and left filtrum along with cupids bow is absent

2. complete cleft palate involves entire primary and secondary palates and extends from alveolar ridge to uvula

It occurs due to non fusion of platatine process of maxilla in anterior one third and horizonal plates of palatine bones in posterior two third

3. Speech requires sound from the vocal fold and airflow from the lungs to be directed into oral cavity for the production of all speech sounds except nasal sound. velum cause closure of posterior phayngeal wall during the speech in order to close off the nasal cavity during oral speech production, and if thos closure is not possible example in cleft palate then it leads to hypernasality

4. m, n and ng are nasal phenomes so they can be produced effectively

5. soft palate elevates and close the nasopharynx during swallowing, in cleft palate this function is improper leading to reflux of food in naspoharrynx