Abstract
The objective of this study is to report comprehensive physical medicine and rehabilitation management of post-palatoplasty in an adolescent patient. The cleft palate repair is usually done in the first year of life in order to gain optimal speech function. To achieve normal communication development, normal hearing, normal oral and pharyngeal structures, adequate stimulation, and reinforcement from the environment for communication efforts are needed. Patient was assessed comprehensively using The International Classification of Functioning, Disability and Health (ICF) and by perceptual assessment for speech. The results showed that after one month intervention, the perceptions of hypernasality in plosive /b/ and affricates /c/ were found reduced significantly. There was improvement in articulation after one month of intervention.
Highlights
Cleft palate is the failure of fusion of the palatal shelves of the maxillary processes, resulting in a cleft of the hard and/or soft palates[1]
The primary palate develops between 4 and 5 weeks of gestation followed by the secondary palate between 8 and 9 weeks of gestation[2]
The etiological factors of Cleft of lip and palate (CL/P) can be grouped into non-genetic i.e. various environmental risk factors – maternal smoking, heavy maternal drinking, maternal disease, stress during pregnancy, increased maternal and paternal age, fetal exposure to retinoid drugs; and genetic i.e. syndromic – associated with other malformation; and nonsyndromic - the cleft is mostly an isolated feature[1]
Summary
Cleft palate is the failure of fusion of the palatal shelves of the maxillary processes, resulting in a cleft of the hard and/or soft palates[1]. In term of speech production, lip and tongue were good; upper second incisives grew behind the first incisives; scar and oral thrush was seen on palate; velopharyngeal mislearning; hypernasality on resonance function; compensatory articulation, glottal stop, weak or omitted consonant on articulation pattern; and the intelligibility was 75%. From the perspective of The International Classification of Functioning, Disability and Health (ICF), the patient’s health condition, body structure, body function, activity, participation, personal and environmental factors can be seen on diagram 1 Health condition of this patient was cleft palate post palatoplasty. Barrier There were friends mocked her Family always help her if she needs communicates verbally with unfamiliar person Rehabilitative goals of this patient were to increase her confidence, to improve her oral hygiene, to decrease hypernasality, and to improve articulation.
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