Abstract
PURPOSE: To verify changes in phonetic, nasometric and aerodynamic aspects of speech in individuals with cleft lip and palate and the influence of occlusion on these variables, before and after orthognathic surgery (OC) for maxillary advancement. METHODS: Retrospective, observational, cross-sectional and analytical study. Fifty-one patients with previously repaired cleft lip and palate participated, 26 men and 25 women (x̅=31 years), who underwent maxillary advancement OC. The following were performed: assessment of phonetic and occlusal aspects, nasometry and aerodynamic assessment of velopharyngeal function (flow-pressure technique), before and after OC. The phonetic aspects were evaluated by 3 experienced judges. RESULTS: There was high intra and inter judge agreement. There was a significant improvement in phonetic production after OC: in tongue interposition ([d], [t], [l], [n], [ʎ]), distortion ([f], [v]) and anterior lisp ([s], [z], [ʃ]). In the occlusal aspects, the overjet reached, on average, the normal values after the OC and there was an occlusal improvement in the anterior crossbite, openbite and overbite. Nasalance values were within the normal range after CO for the nasal text and there was an increase in nasalance, suggestive of hypernasality, in the oral text. There was no change in velopharyngeal closure, in the production of the word "rampa", suggestive of adequate velopharyngeal closure. Occlusion did not influence nasalance and velopharyngeal closure before or after maxillary advancement OC. CONCLUSION: There was a significant improvement in phonetic, occlusal and nasometric aspects after OC. However, none of the phones obtained 100% adequacy,reinforcing the importance of speech therapy after OC.