구개열 보상조음 소거 후 잔존 음성문제의 추적검사: 증례 연구

Follow-up of Residual Voice Problems in Children with Cleft Palate after Elimination of Compensatory Articulation: Case Report

Two female children with cleft palate (aged 68 and 72 months) who previously exhibited compensatory articulation (CA) but achieved resolution through speech therapy were compared to examine residual voice quality differences. Nasalance was measured using Nasometer II (Model 6450), and acoustic parameters (CPP, L/H ratio, F0) were analyzed from sentence samples across vowel contexts using ADSV, alongside GRBAS perceptual ratings. The child with residual voice problems demonstrated higher nasalance scores, especially in high-vowel contexts (mean 25.8%). CPP values showed different patterns across vowel contexts rather than a uniformly lower trend. In contrast, the child without voice problems showed relatively lower nasalance scores and a more favorable perceptual voice profile. Both cases exhibited vowel-dependent variation, with low-vowel contexts yielding higher CPP and L/H ratio values. These findings indicate that voice quality issues may persist even after successful elimination of CA. Multidimensional assessment, including acoustic and perceptual measures, is therefore necessary for ongoing monitoring of children with cleft palate, highlighting the need for continued voice-focused follow-up beyond articulation therapy outcomes.