The effect of maxillary advancement on articulation of alveolar consonants in cleft patients

Introduction: Maxillary advancement may affect speech in cleft patients. The aim of this study was to evaluate the effect of maxillary advancement on Finnish alveolar consonants /s/, /l/, and /r/ in cleft patients.

Materials and methods: Fifty-nine Finnish-speaking nonsyndromic cleft patients, who had undergone Le Fort I or bimaxillary osteotomies, were evaluated retrospectively Production of the Finnish alveolar consonants /s/, /l/, and /r/ was assessed from pre- and postoperative standardized video recordings by two experienced speech pathologists. McNemar's test was used in the statistical analyses. Kappa statistics were calculated to assess reliability.

Results: The patients included 35 females and 24 males with CP (n = 12), UCLP (n = 31), and BCLP (n = 16). There was a significant improvement in /s/ and /l/ sounds after maxillary advancement (p = 0.039 and p = 0.002, respectively). The preoperative mean percentage of /s/ errors was 34%; postoperatively it was 20%. /L/ was misarticulated preoperatively by 34% of the patients and postoperatively by 19%. /R/ was misarticulated preoperatively by 47% of the patients and postoperatively by 42%. The level of mild articulation errors rose from 25% to 31%, while severe articulation errors decreased from 37% to 25%. The reliabilities were good.

Conclusion: When planning orthognathic surgery in cleft patients with maxillary retrusion and articulation errors, advancement of the maxilla might be a means for improving articulation of /s/ and /l/.