Effect of CPAP Therapy on the Speech Characteristics of Repaired Cleft Palate Patients: A Single-Subject Study

Velopharyngeal dysfunctions are frequently reported in patients with repaired cleft palate. For patients with small gap in velopharygeal sphincter, behavior therapy has been suggested to treat their velopharyngeal dysfunction. CPAP therapy, as a behavior therapy, can be used to increase palate muscles strength and to make VP closure complete using a continuous positive airway pressure during speech tasks. The aim of the present study was to determine the effect of CPAP therapy on hypernasality and nasal turbulence in repaired cleft palate patient with small velopharyngeal gap.
A single-subject study was conducted with multiple baselines to study the effect of CPAP therapy on the speech of an eight-year-old boy with repaired cleft palate, small gap in velopharyngeal valve, hypernasality, and nasal turbulence. The participant received CPAP therapy for 48 sessions during two months. Perceptual assessment was done at baseline, during intervention, and in follow-up phases. Visual analysis and Improvement Rate Difference (IRD) were used to analyze data.
The patient showed one-point decrease in the severity of hypernasality on intervention phase and another point decrease occurred on the follow-up phase. This reduction maintained by the end of the study. Also, nasal turbulence was shown to decrease by two points during the intervention phase and therefore normal level was achieved. The achievements were remained unchanged on follow-up phase. The IRD for both parameters were found to be 0/75.
The present study showed that CPAP therapy seems to reduce the severity of hypernasality and nasal turbulence due to strengthen palatal muscles in patients with small velopharyngeal gap.