• Jakwida Jakkabat D.D.S.
• Atiphan Pimkhaokham D.D.S., Ph.D., B.P.A., Diplomate, Thai Board of Oral and Maxillofacial Surgery
• Sittichai Tudsri B.Sc., D.D.S., M.D., B.P.A., Diplomate, Thai Board of Oral and Maxillofacial Surgery
• Nantana Pracharitpukdee M.A.

Objective To evaluate the speech in a group of cleft lip and palate patients after surgical closure of
oronasal fistula compared with normal group and to study the relationship between the compensatory
misarticulation and hypernasality.

Materials and methods Thirty cleft lip and palate patients who had already received the surgical
closure of oronasal fistula more than 6 weeks, age 10-20 years (15.83 ± 2.56) and thirty normal group,
age 11-20 years (15.87 ± 2.44) were evaluated the speech using the 100 monosyllable Thai words and
nasometer. Speech intelligibility score, nasalance score and confusion matrix were statistic analysis
using Independent t test and Mann-Whitney U test. In addition, the relationship between the compensatory
misarticulation and hypernasality was statistic analysis using Pearson correlation.

Results The results showed a significant difference in speech intelligibility score between the cleft
group and normal group (p = 0.001) and also showed a significant difference in nasalance score of the
passage "Tuk Tuk" and "Sai Yok Water Fall" (p = 0.001) but no significant difference in passage
"Manee". The data analysis using confusion matrix indicated that there was significant difference in the
correct sound and non-hypernasality incorrect sound (p = 0.001) but no significant difference in
hypernasality incorrect sound between both groups. The correlation between the compensatory
misarticulation and hypernasality was significant in the passage "Tuk Tuk" and "Sai Yok Water Fall"

Conclusion There was a significant difference in speech ability between cleft lip and palate patients
and normal group especially hypernasality. Moreover, the compensatory misarticulation and hypernasality
were correlated.

(CU Dent J. 2009;32:143-56)