Publications by authors named "Marja-Leena Haapanen"

21 Publications

  • Page 1 of 1

Both Individual and Group-Based Neuropsychological Interventions of Dyslexia Improve Processing Speed in Young Adults: A Randomized Controlled Study.

J Learn Disabil 2020 May/Jun;53(3):213-227. Epub 2019 Dec 24.

University of Helsinki, Finland.

Effectiveness of individual and group-based neuropsychological interventions on cognitive aspects of dyslexia in young adults was evaluated. Dyslexic adults were randomly assigned into individual intervention ( = 40), group intervention ( = 40), or wait-list control group ( = 40). The interventions focused on cognitive strategy learning, supporting self-esteem, and using psychoeducation. Cognitive performance and symptoms were assessed via psychometric testing and self-report questionnaires at baseline, after the intervention/wait-list control time at 5 months and at 10 months. And, 15 months post intervention long-term status was checked via mailed inquiry. Wait-list control group also received an intervention after the 5-month control period. No significant effects were found in primary self-report outcome measures. Both interventions had a positive effect on a measure of processing speed and attention and the effect remained after the 5-month follow-up period. In self-reported cognitive symptoms, a positive trend was evident in self-reported reading habits. Furthermore, minor self-evaluated benefits reaching up to 15 months post intervention were found. There were no significant differences between the results of individual and group intervention as both interventions improved cognitive performance. The results indicate that a structured neuropsychological intervention could be effective in ameliorating dyslexia-related cognitive symptoms in young adults.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0022219419895261DOI Listing
December 2019

[Development of a child's eating and urge for suckling].

Duodecim 2013 ;129(5):473-9

Foniatrian yksikkö, HUS Korvaklinikka.

A child's oral-motor movement models develop from coarse and all-embracing generalized reflexive patterns towards separate, voluntary muscle functions. Development of the oral-motor sensory system begins already during fetal life. Suckling, dealing with and swallowing of food are rhythmic functions that are programmed from foci formed by neural networks of the brainstem. As breast feeding does not seem to completely satisfy children's need for suckling, a pacifier has been offered to bring additional satisfaction. To ensure safe swallowing, the separate stages of eating should be neurologically coordinated with breathing.
View Article and Find Full Text PDF

Download full-text PDF

Source
June 2013

The accessibility of a new oral motor pacifier to infants.

Int J Pediatr Otorhinolaryngol 2012 Dec 6;76(12):1844-8. Epub 2012 Oct 6.

Department of Phoniatrics, Helsinki University Central Hospital, Helsinki University, Faculty of Medicine, PO Box 220, FI-00029 Helsinki, Finland.

Objective: The aim of the present study was to examine whether infants would accept an oral motor pacifier (OMP).

Children And Methods: Sixteen infants were examined for their immediate acceptance of an OMP. The pacifier was regarded as accepted, if the child took it in the mouth and kept it there actively, i.e. sucked it in one way or other. Their parents were informed verbally and in writing literally about how to offer the OMP to the child and how to use it. The OMP was presented to the child and the child permitted to insert it into her/his mouth by her/himself or if the child failed to do so, the OMP was gently put to the child's mouth. The subjects' reactions were structurally evaluated in terms of 11 statements. The parents of the children received a structured questionnaire with a space for optional free comments and personal opinions.

Results: The median age (6 females, 10 males) was 18 months (mean 19.2 months, s.d. 10.6 and range 2-38 months). The statement scores showed no significant differentiation based on the age of the subject. The parents' reports indicated that 14 (87.5%) of the 18 subjects accepted the OMP, 13 (81.3%) enjoyed watching the pacifier as it was shown to them, and 11 (68.8%) explored it with their fingers while holding it in their hands.

Conclusion: The vast majority of the children accepted the new OMP either at the first trial or after a few trials.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijporl.2012.09.017DOI Listing
December 2012

[Treatment of stuttering].

Duodecim 2009 ;125(19):2093-8

Korvaklinikka, foniatrian yksikkö, PL 220, 00029 HUS.

Stuttering in children will usually pass either with therapy or spontaneously. It remains permanent in approx. 20 to 30% of cases. Psychogenic and neurogenic stuttering have an adulthood onset. Behavioral methods aim to change the stutterer's attitude to his/her own speech or to control the extent of stuttering. By using assistive devices it is possible to slow down speech production and thereby increase its fluency. Due to the lack of suitable drugs, pharmacological therapy is seldom used. Moderate and severe stuttering should be treated also in children under school age.
View Article and Find Full Text PDF

Download full-text PDF

Source
January 2010

SPEEDY babies: A putative new behavioral syndrome of unbalanced motor-speech development.

Neuropsychiatr Dis Treat 2008 Dec;4(6):1225-33

Deparment of Otorhinolaryngology, Phoniatric Division, Helsinki University Central Hospital, Haartmaninkatu 4 E, FI-00029 HUS, Helsinki, Finland.

Even though difficulties in motor development in children with speech and language disorders are widely known, hardly any attention is paid to the association between atypically rapidly occurring unassisted walking and delayed speech development. The four children described here presented with a developmental behavioral triad: 1) atypically speedy motor development, 2) impaired expressive speech, and 3) tongue carriage dysfunction resulting in related misarticulations. Those characteristics might be phenotypically or genetically clustered. These children didn't have impaired cognition, neurological or mental disease, defective sense organs, craniofacial dysmorphology or susceptibility to upper respiratory infections, particularly recurrent otitis media. Attention should be paid on discordant and unbalanced achievement of developmental milestones. Present children are termed SPEEDY babies, where SPEEDY refers to rapid independent walking, SPEE and DY to dyspractic or dysfunctional speech development and lingual dysfunction resulting in linguoalveolar misarticulations. SPEEDY babies require health care that recognizes and respects their motor skills and supports their needs for motor activities and on the other hand include treatment for impaired speech. The parents may need advice and support with these children.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646651PMC
http://dx.doi.org/10.2147/ndt.s2640DOI Listing
December 2008

Somatosensory-evoked magnetic fields in examining lip area in speech-disordered children.

J Craniofac Surg 2008 Sep;19(5):1215-20

BioMag Laboratory, Helsinki University Central Hospital, HUSLAB, Helsinki, Finland.

Magnetoencephalography (MEG) is a modern neurophysiological method to study brain activation after sensory stimulation. We aimed at determining the feasibility of MEG and somatosensory-evoked magnetic fields (SEFs) in assessing the lip area in speech-disordered children undergoing oral plate therapy (OPTH) to improve their articulation. Seven subjects (age range, 6-11 years) participated in the study. The speech was perceptually assessed, and the SEFs to tactile stimulation of the lip area were recorded before and after OPTH. Two patients did not attend the posttreatment MEG recording. Clinical perceptual analysis showed remarkable improvement of speech of the studied children after OPTH. Somatosensory-evoked magnetic fields were successfully recorded in 4 of these children, but no constant changes in the responses were found after the therapy.With this small number of patients, the possible modifications in the functioning of the cortical somatosensory area of the lip after OPTH remained undetected. The present method is, however, technically applicable in studying cortical responses to lip stimulation in speech-disordered children. Further studies using stimulation inside the mouth may provide more insight to the cortical effects of OPTH.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0b013e31818433ffDOI Listing
September 2008

Crossmodal temporal processing acuity in children with oral clefts.

Cleft Palate Craniofac J 2008 Jul 9;45(4):393-8. Epub 2008 Mar 9.

Department of Neurology, Lohja Hospital, Sairaalatie 8, Lohja, Finland.

Objective: We have previously found that, in children with certain oral clefts, the rate of sequential information processing is significantly impaired in vision and tactile somatosensation but not so clearly in audition. Here, we studied crossmodal functions by investigating temporal processing acuity of cleft children with audiovisual, audiotactile, and visuotactile tasks.

Participants: Temporal processing acuity was studied in 10-year-old children, 19 with cleft lip with or without cleft palate and 38 with cleft palate or submucous cleft palate.

Design: Children estimated whether brief stimuli of two concurrent three-stimulus sequences, each in a different modality, were simultaneous or not when the stimulus interval varied adaptively. The 8-millisecond stimuli were flashes in vision, tone bursts in audition, and solenoid touches of a finger in somatosensation.

Results: The group with cleft lip with or without cleft palate performed better than the group with cleft palate or submucous cleft palate in audiovisual temporal processing acuity, but the group's superiority was not statistically significant in audiotactile or visuotactile temporal processing acuity.

Conclusions: Audiovisual crossmodal sequential information processing is probably impaired in some cleft children in the group with cleft palate or submucous cleft palate. Our results suggest further studies on the audiovisual capacities of children with cleft.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1597/07-050.1DOI Listing
July 2008

Speech in 6 year old children with sub-mucous cleft palate.

J Craniofac Surg 2007 Jul;18(4):717-22; discussion 723-24

Eye, Ear and Oral Diseases, Rehabilitation Unit, Department of Phoniatrics in Tampere University Hospital, Tampere, Finland.

Speech in 83 children (in total) with sub-mucous cleft palate was evaluated at the age of 6 years. Velopharyngeal insufficiency was graded on the basis of perceptual assessment, taking into account the co-existence of various velopharyngeal insufficiency characteristics in speech. Out of 56 patients operated with a velopharyngeal flap to eliminate velo-pharyngeal insufficiency, 42 of them (75%) achieved normal velopharyngeal function in speech. Dento-alveolar misarticulations were found in 35% of the children. Misar-ticulations occurred independently of velopharyngeal insufficiency.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/scs.0b013e3181468cc9DOI Listing
July 2007

CHERI: time to identify the syndrome?

J Craniofac Surg 2007 Mar;18(2):369-73

Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki, Finland.

Chiari I malformations are congenital abnormalities that are etiologically heterogeneous. Some studies recognize a probable association between Chiari 1 malformation, delayed language or motor development, and mental retardation with or without epilepsy. The present patient appeared to have an isolated cleft palate and Chiari 1 malformation with co-existing functional and behavioral disorders (i.e., speech delay, mental retardation, and deviant electroencephalography [EEG]). In consideration of the cleft palate population, the implication of the present case study is that more attention should be paid to the developmental milestones in children with cleft palate. Because several cases of Chiari I anomaly co-occurring with mental retardation and deviant EEG or epilepsy have been recognized, it appears justified to identify a syndrome, which is here called CHERI (Chiari 1 malformation with or without cleft palate, deviant EEG or epilepsy, and retarded intelligence with delayed language development). It will be important in the future to describe those cases identified to delineate the clinical picture and to estimate the frequency of the occurrence of various characteristics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/scs.0b013e3180336075DOI Listing
March 2007

Changes in articulatory proficiency following microvascular reconstruction in oral or oropharyngeal cancer.

Oral Oncol 2006 Jul 20;42(6):646-52. Epub 2006 Feb 20.

Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Haartmaninkatu 4E, P.O. Box 220, FI-00029 HUS, Helsinki, Finland.

Articulatory proficiency of /r/ and /s/ sounds, voice quality and resonance, speech intelligibility, and intraoral sensation were examined prospectively before operation, and at four time points during a 1-year follow-up after microvascular transfer. Forty-one patients with a large oral or oropharyngeal carcinoma undergoing tumor resection and free-flap reconstruction usually combined with radiotherapy participated in the study. Articulation, voice, and resonance were investigated both live and from recorded speech samples by two trained linguistic examiners. The patients completed a self-rating of their speech intelligibility and were assessed for anterior intraoral surface sensation by means of 2-point moving discrimination. Misarticulations of /r/ and /s/ increased significantly after the therapy. Voice quality and resonance remained essentially normal. Speech intelligibility deteriorated significantly. Intraoral sensation decreased postoperatively but was not related to speech outcome. Sensate flaps did not prove to be superior in relation to speech tasks. A multidisciplinary approach is advocated in assessment of speech outcome after cancer surgery. Speech therapy is strongly recommended, even in the absence of a gross articulatory handicap.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.oraloncology.2005.11.004DOI Listing
July 2006

Swallowing after free-flap reconstruction in patients with oral and pharyngeal cancer.

Oral Oncol 2006 May 20;42(5):501-9. Epub 2005 Dec 20.

Department of Otolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland.

Swallowing and intraoral sensation outcome were investigated prospectively after microvascular free-flap reconstruction. Forty-one patients with a large oral or oropharyngeal carcinoma underwent free-flap surgery usually combined with radiotherapy. The patients completed modified barium swallow, self-rating of swallowing, and 2-point moving discrimination preoperatively and at four time points during the 12-month follow-up period, and a plain chest X-ray one year after operation. Swallowing was impaired with respect to an objective and subjective measure after therapy. Rates for nonsilent and silent aspiration increased during the follow-up. Intraoral sensation deteriorated. Swallowing outcome was not related to sensation. One year after surgery, 86% of the patients ate regular masticated or soft food. Microvascular transfers offer a reasonable option for oral reconstruction. This study does not support the need for sensate flaps. Swallowing problems should be routinely sought and patients rehabilitated during a sufficiently long follow-up with videofluorography regardless of the patient's perception of swallowing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.oraloncology.2005.10.007DOI Listing
May 2006

Speech aerodynamics and nasalance in oral cancer patients treated with microvascular transfers.

J Craniofac Surg 2005 Nov;16(6):990-5; discussion 996

Department of Otolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland.

The purpose of the current study was to assess speech aerodynamics and nasal acoustic energy during a follow-up period of 12 months in patients having undergone microvascular free flap reconstruction after tumor ablation from the oral cavity or oropharynx, usually followed by radiotherapy. Velopharyngeal function was assessed in terms of velopharyngeal orifice size by a pressure-flow measurement technique as well as by determining the instrumental correlate of perceived nasality (i.e., nasalance) during speech production. Velopharyngeal closure and nasalance were estimated to be adequate before operation both in oral cavity and oropharyngeal cancer patients. After the operation, at the group level, the oral cavity patients showed adequate velopharyngeal closure and nasalance. In contrast, the postoperative velopharynx orifice size was significantly bigger in the oropharyngeal cancer patients as compared with the oral cavity patients 6 months after operation. However, based on average aerodynamic as well as the nasalance data, the impairment of velopharyngeal function was not regarded clinically significant at the group level in either group of patients. The present treatment protocol served to maintain the prerequisites for normal or close to normal speech physiology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/01.scs.0000179753.14037.7aDOI Listing
November 2005

Quality of life after free-flap reconstruction in patients with oral and pharyngeal cancer.

Head Neck 2006 Mar;28(3):210-6

Department of Otolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, P. O. Box 220, FIN-00029 HUS, Helsinki, Finland.

Background: Our aim was to investigate quality of life and outcome after microvascular free-flap reconstruction after oncologic surgery.

Methods: Forty-four patients with a large carcinoma in the oral cavity, oral pharynx, or hypopharynx underwent free-flap surgery with or without radiotherapy. Patients completed the University of Washington Quality-of-Life Questionnaire preoperatively and four times during the 12 postoperative months. Survival rates and complications were analyzed.

Results: Postoperative composite quality-of-life scores were significantly lower than before treatment with no significant overall improvement during the follow-up. The scores for disfigurement, chewing, speech, and shoulder function remained significantly below the preoperative level throughout the follow-up. Sociodemographic factors predicted quality of life. Heavy drinking and unemployment caused a 2.4-fold and a 4.4-fold increase in risk of death, respectively. The rates for overall survival, tumor recurrence, flap success, and surgical complications were consistent with previous literature.

Conclusion: Sociodemographic variables affect quality of life and patient survival in patients with oral cancer treated with microvascular free-flap reconstruction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/hed.20329DOI Listing
March 2006

Association between school performance, breast milk intake and fatty acid profile of serum lipids in ten-year-old cleft children.

J Craniofac Surg 2005 Sep;16(5):764-9

Department of Clinical Nutrition, University of Kuopio, Kuopio, Finland.

The fatty acid profiles of serum lipids were examined in 53 ten-year-old cleft children. The children presented with different cleft types (cleft lip, cleft lip and palate, isolated cleft palate and submucuous cleft palate) and were recruited from the Finnish Cleft Center. We also studied associations between serum lipid fatty acids and early breast milk intake, cognitive development in terms of preschool language learning and school achievement. The fatty acid profiles of serum lipids did not differ between boys and girls. The proportion of myristic acid in serum cholesteryl esters (CE) was higher and proportion of nervonic acid in phospholipids (PL) lower in children with isolated palatal clefts than in those with submucuous clefts. Out of the present children, 30% and 60% received breast milk less than 1 or 3 months, respectively. The proportions of docosahexaenoic acid in CE and in PL were significantly higher in the children whose breast milk intake was longer than 3 months. The number of children requiring special education was higher among those who received breast milk less than 1 month than among those with longer breast milk intake. In conclusion, the fatty acid profiles of serum lipids seem to be comparable among children with different cleft types. Short breast milk intake was associated with poorer school performance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/01.scs.0000168758.02040.98DOI Listing
September 2005

Visual, auditory, and tactile temporal processing in children with oral clefts.

J Craniofac Surg 2004 May;15(3):510-8

Department of Psychology, PO Box 9, University of Helsinki, Helsinki University Central Hospital, Siltavuorenpenger 20 C, FIN-00014 Helsinki, Finland.

Neurocognitive disorders may compromise the outcome of surgical cleft lip palate repair and thus need to be identified. Processing of rapidly changing sequential information (temporal processing) is a fundamental neurocognitive capacity that may contribute to various communication functions and has been found impaired in several developmental disorders. The occurrence of temporal processing difficulties in the cleft population is not known, however. We investigated the relation between oral clefting and temporal estimations of simultaneity/nonsimultaneity in visual, auditory, and tactile modalities. Subjects were 10-year-old controls and children with oral clefts of various types [i.e., cleft lip (alveolar), cleft lip and palate, cleft palate, and cleft palate submucous]. The visual and tactile tasks but not so clearly the auditory task differentiated the groups. Further, paralleling previous findings, the patients with cleft lip and palate outperformed the others, whereas the cognitive temporal processing acuity of the cleft palate and cleft palate submucous children was worse.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/00001665-200405000-00033DOI Listing
May 2004

Cephalometric pharyngeal changes after Le Fort I osteotomy in different types of clefts.

Scand J Plast Reconstr Surg Hand Surg 2004 ;38(1):5-10

Cleft Center, Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland.

Fifty patients with clefts (30 unilateral cleft lip and palate (UCLP), 9 bilateral cleft lip and palate (BCLP), and 11 cleft palate only (CP), mean age 25 years) treated with Le Fort I osteotomy were compared retrospectively from cephalograms taken shortly before operation, and at six months and one year postoperatively. Patients with bimaxillary surgery or previous velopharyngoplasty, or both, were excluded. Maxillary advancement was moderate in all groups. One year postoperatively there was a significant change (73%-90% of the surgical advancement) in the sagittal depth of the nasopharyngeal airway but not in the depth of the oropharyngeal airway, the length of the soft palate or the position of the hyoid bone. The nasopharyngeal airway was largest in the CP group both preoperatively and postoperatively. Eleven patients (7 CP, 4 UCLP) had a velopharyngoplasty after the osteotomy to improve their speech. There was no difference in the nasopharyngeal airway in the patients treated by velopharyngoplasty compared with those not so treated, but they seemed to have the shortest maxillas and the greatest surgical changes vertically.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/02844310310009537DOI Listing
July 2004

Long-term effect of pharyngeal flap surgery on craniofacial and nasopharyngeal morphology in patients with cleft palate.

Acta Odontol Scand 2003 Jun;61(3):159-63

Cleft Center, Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland.

The craniofacial morphology of 48 consecutive adult males with isolated cleft palate was studied by means of lateral cephalograms at the mean age of 18.8 years. Twelve of the patients had received pharyngeal flap surgery between 4 and 12 years of age (mean age 6 years) to improve speech. No significant differences were noticed in craniofacial cephalometric relations between the patients who had not had velopharyngeal flap surgery (VPF-) and those who had (VPF+), although the latter showed a tendency toward a more vertical growth direction. In the pharynx, the VPF+ group showed larger sagittal depths of nasopharyngeal airway but smaller depths of oropharyngeal airway. The differences were significant at the levels of the upper nasopharynx and lower oropharynx. According to the hospital records, none of the patients demonstrated persistent airway obstruction. Cephalometry may be useful in evaluating the changes in pharyngeal airway dimensions that may be related to velopharyngeal flap surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/00016350310003846DOI Listing
June 2003

Cephalometric pharyngeal changes after Le Fort I osteotomy in patients with unilateral cleft lip and palate.

Acta Odontol Scand 2002 Jun;60(3):141-5

Cleft Center, Department of Plastic Surgery, Helsinki University Central Hospital, Finland.

Pharyngeal changes after Le Fort I osteotomy were evaluated cephalometrically in 37 patients (27 M, 10 F; mean age 23.8 years) with unilateral cleft lip and palate (UCLP). Seven patients had previously undergone velopharyngeal (VPP) flap surgery to improve speech. One year postoperatively the patients without previous VPP showed a significant change (55%-85% of the surgical change) in the upper and lower sagittal depth of the nasopharyngeal airway, but not in the depth of oropharyngeal airway, length of soft palate, or position of hyoid bone. No significant changes were observed between 6 months and 1 year postoperatively. Mean surgical horizontal advancement was 4.7 mm and the mean vertical lengthening 4.7 mm anteriorly and 1 mm posteriorly. There was a correlation between the amount of horizontal advancement and the amount of change in the nasopharyngeal airway. The patients with previous VPP showed significant postoperative change (85% of the surgical change) only in the lower nasopharyngeal airway, although their surgical advancement was similar to that without previous VPP. Patients with previous VPP showed significantly smaller depths of upper nasopharyngeal airway postoperatively than the patients without previous VPP. Five patients (13%) needed VPP after the osteotomy. There was no difference in the nasopharyngeal airway in the patients with VPP after the osteotomy when compared to those without, but they seemed to have shortest maxillary lengths and largest mean surgical changes vertically both anteriorly (5.5 mm) and posteriorly (2.3 mm). Moderate maxillary advancement in UCLP patients results in significant changes in the nasopharyngeal airway.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/000163502753740142DOI Listing
June 2002

Auditory sensory impairment in children with oral clefts as indexed by auditory event-related potentials.

J Craniofac Surg 2002 Jul;13(4):554-66; discussion 567

Cognitive Brain Research Unit, Department of Psychology, University of Helsinki, Helsinki, Finland.

Children with nonsyndromic oral clefts and with the CATCH 22 syndrome (acronym for cardiac defects, abnormal faces, thymus hypoplasia, clefts, and hypocalcemia) display a range of language and learning disabilities, the neurofunctional bases of which are not yet understood. This review summarizes recent event-related brain potential (ERP) studies on central auditory processing in infants and children with different cleft types and presents an effort to integrate these ERP and earlier behavioral findings into a workable hypothesis on the mechanisms of cognitive impairment in the oral cleft population. The encoding of the acoustic sound features and the functioning of auditory sensory memory (ASM) were studied by recording cortical auditory ERPs. Tapped were two ASM functions: tone pitch discrimination and the duration of sensory memory for tone pitch. In infants with cleft palate, tone pitch discrimination was impaired at birth and at 6 months of age. In infants with cleft lip and palate, no ASM impairment was detected at either age. In school-aged children with clefts and CATCH 22 syndrome, the discrimination of tone pitch was intact under optimal stimulation conditions. However, in these children, shortened duration of ASM was observed, with the magnitude of its shortening covarying with cleft type and being most pronounced in children with CATCH 22 syndrome. The different types of ASM dysfunction found in children with different cleft types could not be accounted for by the peripheral hearing deficits. The relation between ASM dysfunction and known behavioral cognitive disability profiles in children with different cleft types suggests that ASM is implicated in language disabilities of children with oral clefts. Furthermore, it appears that the ASM impairment and oral clefting are linked in a comorbid fashion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/00001665-200207000-00016DOI Listing
July 2002

Craniofacial characteristics and velopharyngeal function in cleft lip/palate children with and without adenoidectomy.

Eur Arch Otorhinolaryngol 2002 Feb;259(2):100-4

Helsinki University Central Hospital, Töölö Hospital, Department of Plastic Surgery, HUS, Finland.

The association between velopharyngeal function, craniofacial morphology and adenoidectomy was investigated using 27 craniofacial and nasopharyngeal variables taken from lateral cephalograms. The sample consisted of 96 boys with cleft palates with or without cleft lips. They were examined at 6 years of age when cephalograms were obtained and perceptual speech assessments were performed. The subjects were divided into three groups: (1) velopharyngeal competence (VPC, n = 45); (2) mild incompetence not requiring velopharyngoplasty (VPI, n = 36); and (3) previous incompetence operated on with velopharyngoplasty ad modum Hoenig (VPP, n = 15) before the 6-year examination. The groups were further divided into two subgroups according to previous adenoidectomy (Ad+, Ad-). The cranial base, size and interrelationship of the maxilla and mandible and their relationship to the cranial base or the bony nasopharynx did not differ among the VPC, VPI and VPP groups. The sagittal depth of the nasopharyngeal airway (Pm-ad1, Pm-ad2, Pm-ad3) was significantly wider in the VPP group than in the the VPC and VPI groups. The previous adenoidectomy decreased the thickness of the posterior pharyngeal wall (ad1-Ba, ad2-so) and thus increased airway size. The length of the velum did not differ between the three groups or their subgroups with and without adenoidectomy. The results showed that adenoidectomy is a risk to velopharyngeal function by widening the nasal airway, but velopharyngeal incompetence cannot definitely be attributed to adenoidectomy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s004050100417DOI Listing
February 2002