Speech and Brain Function in Subjects with Cleft Lip and Palate-

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Subjects with cleft lip and palate (CLP) often have problematic articulators such as a stiff upper lip and uvula, congenital loss and dislocation of maxillary teeth. These factors may make the patient with CLP manage to substitute different place and manner of articulation 1101. Adaptation to impaired articulatory environment through novel strategies utilizing restricted perioral structures implicates a plasticity of central neural network. A comprehensive approach from brain function and peripheral movement is necessary to understand speech function in subjects with CLP. First, cortical representation of articulation of, bilabial, alveolar and velar consonants in subjects with CLP was studied by Lising functional magnetic resonance imaging (fMRI). Activation foci were found in the bilateral primary sensorimotor cortex (SI/MI) in all CLP subjects during articulation of /pa/, /ta/ and /ka/. The Si/MI ipsilateral to the CLP showed greater activation in patients with unilateral CLP, where … More as the SI/MI contralateral to the side, on which earlier cheiloplasty was performed, showed greater activation in the subject with bilateral CLP. The results suggest that there be a difference in the cortical consonant may activation pattern during consonant articulation, which is related to the side of CLP. Second, dynamic changes in oropharyngeal structures during the articulation of /pa/, /ta/ and /ka/ by a subject with CLP and a normal adult male volunteer were assessed by MRI movie. Different patterns were observed during articulation in the subject with CLP compared to the normal volunteer. Posterosuperior movement of the tongue and the anterior movement of the posterior pharyngeal wall were clearly visualized in the subject with CLP. Thus, MRI movie appears to be a promising tool for evaluating speech function in subjects with CLP because of its non-invasive and non-radiative nature. We are currently working on compensatory brain function that is associated with compensatory articulatory movement. Less