{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:14:43Z","timestamp":1773850483606,"version":"3.50.1"},"reference-count":34,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T00:00:00Z","timestamp":1634083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T00:00:00Z","timestamp":1634083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Folia Phoniatr Logop"],"published-print":{"date-parts":[[2022]]},"abstract":"<b><i>Introduction:<\/i><\/b> Abnormal facial growth is a recognized outcome in cleft lip and palate (CLP), resulting in a concave profile and a class III occlusal status. Maxillary osteotomy (MO) is undertaken to correct this facial deformity, and the surgery can impact speech articulation, although the evidence remains limited and ill-defined for the CLP population. <b><i>Aims:<\/i><\/b> The aim of the study was to investigate the impact of MO on the production of the fricatives \/f\/ and \/s\/, using perceptual and acoustic analyses, and to explore the nature of speech changes. <b><i>Methods:<\/i><\/b> Twenty participants with CLP were seen 0\u20133 months pre-operatively (T1) and 3 months (T2) and 12 months (T3) after MO. A normal group (<i>N<\/i> = 20) was similarly recruited. Perceptual speech data was collected according to a validated framework and ratings made on audio and audio-video recordings (VIDRat). Spectral moments were centre of gravity (CG), standard deviation (SD), skewness (SK) and kurtosis (KU). Reliability studies were carried out for all speech analyses. <b><i>Results:<\/i><\/b> For the CLP group, VIDRat identified dentalization\/interdentalization as the main type of pre-operative error for \/s\/ with a statistically significant improvement over time, \u03c7<sup>2<\/sup>(2) = 6.889, <i>p<\/i> = 0.032. Effect sizes were medium between T1 and T3 (<i>d<\/i> = 0.631) and small between T2 and T3 (<i>d<\/i> = 0.194). For the acoustic data, effect sizes were similarly medium between T1 and T2 (e.g., SK, \/f\/ <i>d<\/i> = 0.579, \/s\/ <i>d<\/i> = 0.642) and small between T1 and T3 across all acoustic parameters. Independent <i>t<\/i> tests showed mainly statistically significant differences between both groups at all time points with large effect sizes (e.g., T2 CG, <i>t<\/i> = \u20134.571, <i>p<\/i> &#x3c; 0.001, <i>d =<\/i>1.581), indicating that \/s\/ was not normalized post-operatively. For \/f\/, differences tended to be at T1 with large effect sizes (e.g., CG, <i>t<\/i> = \u20132.307, <i>p<\/i> = 0.028, <i>d<\/i> = 0.797), reflecting normalization. <b><i>Conclusions and Implications:<\/i><\/b> This is the first speech acoustic study on \/f\/ for individuals with CLP undergoing MO. The surgery has a positive impact on \/f\/ and \/s\/, which appear to stabilize 3 months post-operatively. Speech changes are an automatic and a direct consequence of the physical changes brought about by MO, effecting articulatory re-organization. The results of the study have direct clinical implications for the clinical care pathway for patients with CLP undergoing MO. <\/jats:p>","DOI":"10.1159\/000520080","type":"journal-article","created":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T21:01:56Z","timestamp":1634158916000},"page":"271-283","source":"Crossref","is-referenced-by-count":6,"title":["The Impact of Maxillary Osteotomy on Fricatives in Cleft Lip and Palate: A Perceptual Speech and Acoustic Study"],"prefix":"10.1159","volume":"74","author":[{"given":"Joy\u00a0M.K.","family":"Tsang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3980-284X","authenticated-orcid":false,"given":"Wilson\u00a0S.","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jyrki","family":"Tuomainen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie","family":"Sell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathy\u00a0Y.S.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael\u00a0C.F.","family":"Tong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie\u00a0J.","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2021,10,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1991_028_0022_asofgi_2.3.co_2"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.3140.335"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/9780470988244"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1597\/08-176.1"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1597\/06-075.1"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2005.06.008"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2010.03.011"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1177\/1055665620947626"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001734"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1597\/12-304"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569(2003)040<0054:EOOSOS>2.0.CO;2"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/0278-2391(90)90481-G"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/9.2.144"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2015.12.015"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(10)80101-6"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1053\/joms.2002.31221"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2007.04.001"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1597\/11-116"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0503(80)80100-7"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9416(84)90139-8"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9416(86)90038-2"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618784804"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1159\/000266422"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9924(99)00004-0"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1597\/04-141.1"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1044\/jshr.3103.449"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1121\/1.1288413"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1080\/13682820802196815"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2012\/11-0080)"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2006.02.009"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1597\/10-145"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1044\/2020_LSHSS-19-00122"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.170289"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015467"}],"container-title":["Folia 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