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Damak ± Dudak Yarıklı Bireylerde İşitme ve Dil Gelişiminin Değerlendirilmesi

Year 2017, Volume 4, Issue 3, 72 - 85, 29.12.2017
https://doi.org/10.21020/husbfd.363278

Abstract

Amaç: Damak ± dudak yarıklı çocukların büyük kısmında yaşamlarının ilk yıllarında otitis mediaya bağlı iletim tip işitme kaybı görülür. Bu duruma gerekli müdahalelerin yapılmayarak işitme kayıplı geçirilen sürenin uzaması ya da işitme kaybının kalıcı hale dönüşmesi dil gelişimini olumsuz yönde etkileyebilmektedir. Bu çalışmada amacımız ünitemize başvuran damak ± dudak yarıklı bireylerin işitmelerini değerlendirerek, kayıp varsa işitme kaybı tipini belirlemek ve işitme kaybı olmayan damak ± dudak yarıklı çocukların dil becerilerinin değerlendirmektir.

Gereç-Yöntem: Çalışma Nisan 2014 ile Haziran 2017 tarihleri arasında Gazi Üniversitesi KBB Anabilim Dalı Odyoloji, Konuşma, Ses ve Denge Merkezi’nde yürütülmüştür. Çalışmaya yaşları 2 ile 20 arasında değişen 30 damak ± dudak yarıklı olgu katılmıştır. Olguların tümü damak ± dudak açısından cerrahi operasyon geçirmişlerdir. Bireylere önce otolojik muayene ve odyolojik değerlendirme yapılarak işitme kaybı varsa tipi belirlenmiştir. İşitme kaybı olmayan 2-7 yaş arası olgulara dil değerlendirmesi yapılmıştır.

Bulgular: Çalışmaya katılan olguların %30’unda işitme kaybı belirlenmiştir. İşitme kaybı olan olguların

%88’inde iletim tipi işitme kaybı; %12’sinde sensörinöral tip işitme kaybı görülmüştür.  Dil değerlendirilmesi yapılan 11 olgudan 3’ünde (%27) alıcı dil becerilerinde gerilik olduğu, 7’sinde (%63) ifade edici dil becerilerinde gerilik olduğu gözlenmiştir. Sözel dil performansına bakıldığında vakalardan 4’ünün (%36) dil becerilerinde gerilik olduğu görülmüştür.

Sonuç:  Damak ± dudak yarıklı olgularda düzenli otolojik ve odyolojik takibi büyük önem taşımaktadır. İşitme kaybı olmayan damak ± dudak yarıklı çocuklarda yüksek oranda görülen dil gecikmesi/bozukluğu bu vakalardaki dil gelişimi değerlendirilmesi gereksinimini vurgulamaktadır. Çalışma bu bireylerin multidisipliner bir ekip tarafından takip edilmesi ihtiyacını ortaya çıkarmaktadır.

References

  • Broen, P. A., Moller, K. T., Carlstrom, J., Doyle, S. S., Devers, M., & Keenan, K. M. (1996). Comparison of the hearing histories of children with and without cleft palate. The Cleft palate-craniofacial journal, 33(2), 127-133.
  • Cazden, C. B. (2001). The language of teaching and learning. The language of teaching and learning, 348-369.
  • Conrad, A. L., Richman, L., Nopoulos, P., & Dailey, S. (2009). Neuropsychological functioning in children with non-syndromic cleft of the lip and/or palate. Child Neuropsychology, 15(5), 471-484.
  • Fox, D., Lynch, J., & Brookshire, B. (1978). Selected developmental factors of cleft palate children between two and thirty-three months of age. The Cleft palate journal, 15(3), 239-245.
  • Friel-Patti, S., Finitzo-Hieber, T., Conti, G., & Brown, K. C. (1982). Language delay in infants associated with middle ear disease and mild, fluctuating hearing impairment. The Pediatric Infectious Disease Journal, 1(2), 104-109.
  • Gani, B., Kinshuck, A., & Sharma, R. (2012). A review of hearing loss in cleft palate patients. International journal of otolaryngology, 2012.
  • Goudy, S., Lott, D., Canady, J., & Smith, R. J. (2006). Conductive hearing loss and otopathology in cleft palate patients. Otolaryngology—Head and Neck Surgery, 134(6), 946-948.
  • Groenewald, H., Kritzinger, A., & Viviers, M. (2013). Age-specific communication functioning of young children with cleft lip and palate in a South African Database. The Cleft palate-craniofacial journal, 50(6), 717-729.
  • Güven, S., & Topbaş, S. (2014). Erken Dil Gelişimi Testi-Üçüncü Versiyonu'nun (Test of Early Language Development-) Türkçe'ye Uyarlama, Geçerlik ve Güvenirlik Ön Çalışması. International Journal of Early Childhood Special Education, 6(2).
  • Handžić-Ćuk, J., Ćuk, V., Rišavi, R., Katušić, D., & Štajner-Katušić, S. (1996). Hearing levels and age in cleft palate patients. International journal of pediatric otorhinolaryngology, 37(3), 227-242.
  • Hardin-Jones, M., & Chapman, K. L. (2014). Early lexical characteristics of toddlers with cleft lip and palate. The Cleft palate-craniofacial journal, 51(6), 622-631.
  • Jerger, J.F. (1970). Clinical experience with impedence audiometry. Archives of Otolaryngology, 92, 311-324.
  • Jocelyn, L. J., Penko, M. A., & Rode, H. L. (1996). Cognition, communication, and hearing in young children with cleft lip and palate and in control children: a longitudinal study. Pediatrics, 97(4), 529-534.
  • Kapp-Simon, K. A., & Krueckeberg, S. (2000). Mental development in infants with cleft lip and/or palate. The Cleft palate-craniofacial journal, 37(1), 65-70.
  • Kernahan, D. A., & Stark, R. B. (1958). A new classification for cleft lip and cleft palate. Plastic and Reconstructive Surgery, 22(5), 435-441.
  • Kim, S. Y., Bothwell, N. E., & Backous, D. D. (2002). The expanding role of the otolaryngologist in managing infants and children with hearing loss. Otolaryngologic Clinics of North America, 35(4), 699-710.
  • Kuehn, D. P., & Moller, K. T. (2000). Speech and language issues in the cleft palate population: the state of the art. The Cleft palate-craniofacial journal, 37(4), 348-348.
  • Kwan, W. M., Abdullah, V. J., Liu, K., van Hasselt, C. A., & Tong, M. C. (2011). Otitis media with effusion and hearing loss in Chinese children with cleft lip and palate. The Cleft palate-craniofacial journal, 48(6), 684-689.
  • Lu, Z., Ma, L., Luo, Y., & Fletcher, P. (2010). The effects of unrepaired cleft palate on early language development in Chinese infants. The Cleft palate-craniofacial journal, 47(4), 400-404.
  • Luthra, S., Singh, S., Nagarkar, A. N., & Mahajan, J. K. (2009). The role of audiological diagnostics in children with cleft lip & palate (CLP). International journal of pediatric otorhinolaryngology, 73(10), 1365-1367.
  • Montirosso, R., Fedeli, C., Murray, L., Morandi, F., Brusati, R., Perego, G. G., & Borgatti, R. (2011). The role of negative maternal affective states and infant temperament in early interactions between infants with cleft lip and their mothers. Journal of pediatric psychology, 37(2), 241-250.
  • Morris, H., & Ozanne, A. (2003). Phonetic, phonological, and language skills of children with a cleft palate. The Cleft palate-craniofacial journal, 40(5), 460-470.
  • Mossey, P. A., Little, J., Munger, R. G., Dixon, M. J., & Shaw, W. C. (2009). Cleft lip and palate. The Lancet, 374(9703), 1773-1785.
  • Nation, J. E. (1970). Vocabulary comprehension and usage of preschool cleft palate and normal children. The Cleft palate journal, 7, 639.
  • Neiman, G. S., & Savage, H. E. (1997). Development of infants and toddlers with clefts from birth to three years of age. The Cleft palate-craniofacial journal, 34(3), 218-225.
  • Pannbacker, M. (1969). Hearing loss and cleft palate. The Cleft palate journal, 6(1), 50-56.
  • Paradise, J. L., & Bluestone, C. D. (1974). Early treatment of the universal otitis media of infants with cleft palate. Pediatrics, 53(1), 48-54.
  • Pushpavathi, M., Vijayan, K., & Vishwanath, A. (2017). Effectiveness of early intervention on awareness and communication behaviors of mothers of toddlers with repaired cleft lip and palate. Journal of Cleft Lip Palate and Craniofacial Anomalies, 4(3), 88.
  • Richman, L. C., McCoy, T. E., Conrad, A. L., & Nopoulos, P. C. (2012). Neuropsychological, behavioral, and academic sequelae of cleft: early developmental, school age, and adolescent/young adult outcomes. The Cleft palate-craniofacial journal, 49(4), 387-396.
  • Rosenfeld, R. M., Shin, J. J., Schwartz, S. R., Coggins, R., Gagnon, L., Hackell, J. M., . . . Payne, S. C. (2016). Clinical practice guideline: otitis media with effusion (update). Otolaryngology–Head and Neck Surgery, 154(1_suppl), S1-S41.
  • Scherer, N. J., Boyce, S., & Martin, G. (2013). Pre-linguistic children with cleft palate: Growth of gesture, vocalization, and word use. International Journal of Speech-Language Pathology, 15(6), 586-592.
  • Scherer, N. J., & D'Antonio, L. L. (1995). Parent questionnaire for screening early language development in children with cleft palate. The Cleft palate-craniofacial journal, 32(1), 7-13.
  • Scherer, N. J., D'antonio, L. L., & McGahey, H. (2008). Early intervention for speech impairment in children with cleft palate. The Cleft palate-craniofacial journal, 45(1), 18-31.
  • Scherer, N. J., Williams, L., Stoel-Gammon, C., & Kaiser, A. (2012). Assessment of single-word production for children under three years of age: comparison of children with and without cleft palate. International journal of otolaryngology, 2012.
  • Smith, R. M., & McWilliams, B. J. (1968). Psycholinguistic abilities of children with clefts. Cleft Palate J, 5, 238-249.
  • Speltz, M. L., Endriga, M. C., Hill, S., Maris, C. L., Jones, K., & Omnell, M. L. (2000). Brief report: cognitive and psychomotor development of infants with orofacial clefts. Journal of pediatric psychology, 25(3), 185-190.
  • Spriestersbach, D. C., Darley, F. L., & Morris, H. L. (1958). Language skills in children with cleft palates. Journal of Speech, Language, and Hearing Research, 1(3), 279-285.
  • Szabo, C., Langevin, K., Schoem, S., & Mabry, K. (2010). Treatment of persistent middle ear effusion in cleft palate patients. International journal of pediatric otorhinolaryngology, 74(8), 874-877.
  • Tunçbi̇lek, G., Özgür, F., & Belgi̇n, E. (2003). Audiologic and tympanometric findings in children with cleft lip and palate. The Cleft palate-craniofacial journal, 40(3), 304-309.
  • Wasserman, G. A., Allen, R., & Linares, L. O. (1988). Maternal interaction and language development in children with and without speech-related anomalies. Journal of communication disorders, 21(4), 319-331.

Assessment of Hearing and Language Development in Individuals with Cleft Lip Palate

Year 2017, Volume 4, Issue 3, 72 - 85, 29.12.2017
https://doi.org/10.21020/husbfd.363278

Abstract

Objectives: Most children with cleft palate±lip  have conductive-type hearing loss due to otitis media in the  first years of life. Due to not presenting required interventions can affect language development negatively. In this study, we aimed to evaluate the hearing and determine the type of hearing loss and to evaluate the linguistic skills of children with palate and lips without hearing loss.

Materıals and Methods: The study was conducted in ENT, Audiology and Speech Disorders department at Gazi University  between April 2014 and June 2017. 30 patient  aging range from 2 to 20,  with cleft lip±palate were included in the study. First, hearing assessments were performed and  hearing loss type were identified  if persons have hearing loss, type of hearing loss were identified. Then, language assessments were made on 2-7 year old children who have no hearing loss.

Results: Among persons who have hearing loss (%30), it was observed that,  88% of cases have conductive type and  12% of cases have.sensorineural hearing loss.

Receptive and expressive language assesment were conducted to 11 cases between the ages of 2 to 7. It was observed that 3 (%27) participant had receptive language delay and 7 (%63) had delays in expressive language skills.

Conclusion: Regular otological and audiologic follow-up is important for children with cleft lip±palate. The high rate of language impairment in children with Cleft palate ± lip without hearing loss emphasizes that there is need to assess language development of these children. The study reveals, there is  need for these children to be monitored by a multidisciplinary team.

References

  • Broen, P. A., Moller, K. T., Carlstrom, J., Doyle, S. S., Devers, M., & Keenan, K. M. (1996). Comparison of the hearing histories of children with and without cleft palate. The Cleft palate-craniofacial journal, 33(2), 127-133.
  • Cazden, C. B. (2001). The language of teaching and learning. The language of teaching and learning, 348-369.
  • Conrad, A. L., Richman, L., Nopoulos, P., & Dailey, S. (2009). Neuropsychological functioning in children with non-syndromic cleft of the lip and/or palate. Child Neuropsychology, 15(5), 471-484.
  • Fox, D., Lynch, J., & Brookshire, B. (1978). Selected developmental factors of cleft palate children between two and thirty-three months of age. The Cleft palate journal, 15(3), 239-245.
  • Friel-Patti, S., Finitzo-Hieber, T., Conti, G., & Brown, K. C. (1982). Language delay in infants associated with middle ear disease and mild, fluctuating hearing impairment. The Pediatric Infectious Disease Journal, 1(2), 104-109.
  • Gani, B., Kinshuck, A., & Sharma, R. (2012). A review of hearing loss in cleft palate patients. International journal of otolaryngology, 2012.
  • Goudy, S., Lott, D., Canady, J., & Smith, R. J. (2006). Conductive hearing loss and otopathology in cleft palate patients. Otolaryngology—Head and Neck Surgery, 134(6), 946-948.
  • Groenewald, H., Kritzinger, A., & Viviers, M. (2013). Age-specific communication functioning of young children with cleft lip and palate in a South African Database. The Cleft palate-craniofacial journal, 50(6), 717-729.
  • Güven, S., & Topbaş, S. (2014). Erken Dil Gelişimi Testi-Üçüncü Versiyonu'nun (Test of Early Language Development-) Türkçe'ye Uyarlama, Geçerlik ve Güvenirlik Ön Çalışması. International Journal of Early Childhood Special Education, 6(2).
  • Handžić-Ćuk, J., Ćuk, V., Rišavi, R., Katušić, D., & Štajner-Katušić, S. (1996). Hearing levels and age in cleft palate patients. International journal of pediatric otorhinolaryngology, 37(3), 227-242.
  • Hardin-Jones, M., & Chapman, K. L. (2014). Early lexical characteristics of toddlers with cleft lip and palate. The Cleft palate-craniofacial journal, 51(6), 622-631.
  • Jerger, J.F. (1970). Clinical experience with impedence audiometry. Archives of Otolaryngology, 92, 311-324.
  • Jocelyn, L. J., Penko, M. A., & Rode, H. L. (1996). Cognition, communication, and hearing in young children with cleft lip and palate and in control children: a longitudinal study. Pediatrics, 97(4), 529-534.
  • Kapp-Simon, K. A., & Krueckeberg, S. (2000). Mental development in infants with cleft lip and/or palate. The Cleft palate-craniofacial journal, 37(1), 65-70.
  • Kernahan, D. A., & Stark, R. B. (1958). A new classification for cleft lip and cleft palate. Plastic and Reconstructive Surgery, 22(5), 435-441.
  • Kim, S. Y., Bothwell, N. E., & Backous, D. D. (2002). The expanding role of the otolaryngologist in managing infants and children with hearing loss. Otolaryngologic Clinics of North America, 35(4), 699-710.
  • Kuehn, D. P., & Moller, K. T. (2000). Speech and language issues in the cleft palate population: the state of the art. The Cleft palate-craniofacial journal, 37(4), 348-348.
  • Kwan, W. M., Abdullah, V. J., Liu, K., van Hasselt, C. A., & Tong, M. C. (2011). Otitis media with effusion and hearing loss in Chinese children with cleft lip and palate. The Cleft palate-craniofacial journal, 48(6), 684-689.
  • Lu, Z., Ma, L., Luo, Y., & Fletcher, P. (2010). The effects of unrepaired cleft palate on early language development in Chinese infants. The Cleft palate-craniofacial journal, 47(4), 400-404.
  • Luthra, S., Singh, S., Nagarkar, A. N., & Mahajan, J. K. (2009). The role of audiological diagnostics in children with cleft lip & palate (CLP). International journal of pediatric otorhinolaryngology, 73(10), 1365-1367.
  • Montirosso, R., Fedeli, C., Murray, L., Morandi, F., Brusati, R., Perego, G. G., & Borgatti, R. (2011). The role of negative maternal affective states and infant temperament in early interactions between infants with cleft lip and their mothers. Journal of pediatric psychology, 37(2), 241-250.
  • Morris, H., & Ozanne, A. (2003). Phonetic, phonological, and language skills of children with a cleft palate. The Cleft palate-craniofacial journal, 40(5), 460-470.
  • Mossey, P. A., Little, J., Munger, R. G., Dixon, M. J., & Shaw, W. C. (2009). Cleft lip and palate. The Lancet, 374(9703), 1773-1785.
  • Nation, J. E. (1970). Vocabulary comprehension and usage of preschool cleft palate and normal children. The Cleft palate journal, 7, 639.
  • Neiman, G. S., & Savage, H. E. (1997). Development of infants and toddlers with clefts from birth to three years of age. The Cleft palate-craniofacial journal, 34(3), 218-225.
  • Pannbacker, M. (1969). Hearing loss and cleft palate. The Cleft palate journal, 6(1), 50-56.
  • Paradise, J. L., & Bluestone, C. D. (1974). Early treatment of the universal otitis media of infants with cleft palate. Pediatrics, 53(1), 48-54.
  • Pushpavathi, M., Vijayan, K., & Vishwanath, A. (2017). Effectiveness of early intervention on awareness and communication behaviors of mothers of toddlers with repaired cleft lip and palate. Journal of Cleft Lip Palate and Craniofacial Anomalies, 4(3), 88.
  • Richman, L. C., McCoy, T. E., Conrad, A. L., & Nopoulos, P. C. (2012). Neuropsychological, behavioral, and academic sequelae of cleft: early developmental, school age, and adolescent/young adult outcomes. The Cleft palate-craniofacial journal, 49(4), 387-396.
  • Rosenfeld, R. M., Shin, J. J., Schwartz, S. R., Coggins, R., Gagnon, L., Hackell, J. M., . . . Payne, S. C. (2016). Clinical practice guideline: otitis media with effusion (update). Otolaryngology–Head and Neck Surgery, 154(1_suppl), S1-S41.
  • Scherer, N. J., Boyce, S., & Martin, G. (2013). Pre-linguistic children with cleft palate: Growth of gesture, vocalization, and word use. International Journal of Speech-Language Pathology, 15(6), 586-592.
  • Scherer, N. J., & D'Antonio, L. L. (1995). Parent questionnaire for screening early language development in children with cleft palate. The Cleft palate-craniofacial journal, 32(1), 7-13.
  • Scherer, N. J., D'antonio, L. L., & McGahey, H. (2008). Early intervention for speech impairment in children with cleft palate. The Cleft palate-craniofacial journal, 45(1), 18-31.
  • Scherer, N. J., Williams, L., Stoel-Gammon, C., & Kaiser, A. (2012). Assessment of single-word production for children under three years of age: comparison of children with and without cleft palate. International journal of otolaryngology, 2012.
  • Smith, R. M., & McWilliams, B. J. (1968). Psycholinguistic abilities of children with clefts. Cleft Palate J, 5, 238-249.
  • Speltz, M. L., Endriga, M. C., Hill, S., Maris, C. L., Jones, K., & Omnell, M. L. (2000). Brief report: cognitive and psychomotor development of infants with orofacial clefts. Journal of pediatric psychology, 25(3), 185-190.
  • Spriestersbach, D. C., Darley, F. L., & Morris, H. L. (1958). Language skills in children with cleft palates. Journal of Speech, Language, and Hearing Research, 1(3), 279-285.
  • Szabo, C., Langevin, K., Schoem, S., & Mabry, K. (2010). Treatment of persistent middle ear effusion in cleft palate patients. International journal of pediatric otorhinolaryngology, 74(8), 874-877.
  • Tunçbi̇lek, G., Özgür, F., & Belgi̇n, E. (2003). Audiologic and tympanometric findings in children with cleft lip and palate. The Cleft palate-craniofacial journal, 40(3), 304-309.
  • Wasserman, G. A., Allen, R., & Linares, L. O. (1988). Maternal interaction and language development in children with and without speech-related anomalies. Journal of communication disorders, 21(4), 319-331.

Details

Subjects Health Care Sciences and Services
Journal Section Articles
Authors

Şadiye BACIK TIRANK (Primary Author)
0000-0002-3378-0862
Türkiye


Melis KESKİN This is me


Güzide ATALIK
GAZİ ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ, DİL VE KONUŞMA TERAPİSİ BÖLÜMÜ
Türkiye


Gurbet Şahin KAMIŞLI This is me


Hakan TUTAR This is me


Bülent GÜNDÜZ This is me

Publication Date December 29, 2017
Application Date December 6, 2017
Acceptance Date December 12, 2017
Published in Issue Year 2017, Volume 4, Issue 3

Cite

APA Bacık Tırank, Ş. , Keskin, M. , Atalık, G. , Kamışlı, G. Ş. , Tutar, H. & Gündüz, B. (2017). Assessment of Hearing and Language Development in Individuals with Cleft Lip Palate . Hacettepe University Faculty of Health Sciences Journal , 4 (3) , 72-85 . DOI: 10.21020/husbfd.363278