Influența protocolului de intervenție chirurgicală ales în cazul despicăturilor facio-labio-palatine asupra procesului de intervenție logopedică

Influența protocolului de intervenție chirurgicală ales în cazul despicăturilor facio-labio-palatine asupra procesului de intervenție logopedică

The influence of the surgical intervention protocol chosen in the case of facio-labio-palatine clefts on the speech therapy intervention process


Labio-maxillo-palatine clefts is the most common congenital anomaly among congenital malformations of the face. The approach to clefts is done within a multidisciplinary team, in a management that starts from the pre-natal or immediately post-natal period until the adult life of the patient. The surgical protocol chosen for lip and palate reconstruction is a significant step for the upcoming speech process. The purpose of the paper is to highlight the importance of the surgical intervention protocol in the case of clefts, taking into account the speech difficulties that may occur and the therapeutic process of speech therapy intervention that can take place over a significant period of time. We highlighted this aspect through two presented case studies.

Keywords:labio-maxillo-palatine cleft, open rhinolalia, palatal fistula, speech intelligibility, speech disorder

Published on line: 03/31/2023
Bodea Hațegan, C. (2016). Terapia tulburărilor de limbaj. Structurilor deschise, Ed. Trei, București.
Bodea Haţegan, C. (2022). Tulburările de voce și vorbire: evaluare și intervenție, editura ASTTLR, Cluj-Napoca.
De Mey, A., Franck, D., Cuylits, N., Swennen, G., Malevez, C., Lejour, M. (2009). Early one-stage repair of complete unilateral cleft lip and palate. J Craniofac Surg 20(Suppl. 2): 1723e1728.
Farina, R. (1958). Total unilateral harelip: correction of severe deformity of the palate and lips in a single operation; Le Mesurier’s cheiloplasty & Veau-Ernst’s gnathourano- staphyloplasty. Ann Chir Plast 3: 199e205.
Farronato, G., Kairyte, L., Giannini, L., Galbiati, G., Maspero, C. (2014). How various surgical protocols of the unilateral cleft lip and palate influence the facial growth and possible orthodontic problems? Which is the best timing of lip, palate and alveolus repair? literature review. Available online at
Fayyaz, G.Q., Ganatra, M.A. (2021). Palatal Fistulas and Repair. Global Cleft Care in Low-Resource Settings pp 199–232
Fudalej, P., Hortis-Dzierzbicka, M., Dudkiewicz, Z., Semb, G. (2009). Dental arch relationship in children with complete unilateral cleft lip and palate following Warsaw (one-stage repair) and Oslo protocols. Cleft Palate Craniofac J 46: 648e653
Fudalej, P., Katsaros, C., Bongaarts, C., Dudkiewicz, Z., Kuijpers-Jagtman, A.M. (2009). Nasolabial esthetics in children with complete unilateral cleft lip and palate after 1- versus 3-stage treatment protocols. J Oral Maxillofac Surg 67: 1661e1666
Fudalej, P.S., Wegrodzka, E., Semb, G., Hortis-Dzierzbicka, M. (2015). One-stage (Warsaw) and two-stage (Oslo) repair of unilateral cleft lip and palate: Craniofacial outcomes, Journal of Cranio-Maxillo-Facial Surgery 43 (2015) 1224e1231,
Hortis-Dzierzbicka, M., Radkowska, E., Fudalej, P.S. (2012). Speech outcomes in 10-year-old children with complete unilateral cleft lip and palate after one-stage lip and palate repair in the first year of life. J Plast Reconstr Aesthet Surg 65: 175e181
Malek, R. (2001). Cleft lip and palate: lesions, pathophysiology and primary treatment, Taylor & Francis.
Orian, I.M. (2021). Abordarea interdisciplinară a despicăturilor facio-labio-palatine, DOI: 10.26744/rrttlc.2021.7.1.04
Pisula, E., Lukowska, E., Fudalej, P.S. (2014). Self-esteem, coping styles, and quality of life in Polish adolescents and young adults with unilateral cleft lip and palate. Cleft Palate Craniofac J 51: 290e299
Savaci, N., Hosnuter, M., Tosun, Z., Demir, A. (2005): Maxillofacial morphology in children with complete unilateral cleft lip and palate treated by one-stage simultaneous repair. Plast Reconstr Surg 115: 1509e1517.
Shaw, W.C., Semb, G., Nelson, P., Brattstrom, V., Mølsted, K., Prahl-Andersen, B. (2000). The Eurocleft project 1996-2000. Standards of care for cleft lip and palate in Europe. doi: 10.1016/j.anplas.2014.08.004.
Tote, R., Munteanu, S., Pascu, A., Purav, D., Stancu, D., Oruc, V., Komini, E., Melian, G., Zetu, I., (2014). Aspecte clinico-terapeutice ale despicăturilor labio-maxilo-palatine: date din lieratură, Romanian Journal of Medical and Dental Education, vol.3, issue 1, January-June 2014.
Vanderas, A.P. (1987). Incidence of cleft lip, cleft palate, and cleft lip and palate among races: a review. Cleft Palate J. 1987; 24(3):216–225.
Yoshikazu, N., Nagato, N., Tomoki, K., Toko, H. (2011). Epidemiological Analysis of Cleft Lip and/or Palate by Cleft Pattern. J Maxillofac Oral Surg. 2010 Dec; 9(4): 389–395. Published online 2011 Mar 11. doi: 10.1007/s12663-010-0132-6.

Abordarea interdisciplinară a despicăturilor facio-labio-palatine

Abordarea interdisciplinară a despicăturilor facio-labio-palatine

Interdisciplinary approach to facio-labio-palatine clefts

Ioana Mădălina ORIAN

Labio-maxillo-palatine clefts represent the most common congenital anomaly of all congenital malformations of the face and they are the most frequent cause of rhinolic disorders. The complexity of the therapeutic approach is determined by nutrition and eating problems, hearing and ENT problems, dento-facial and orthodontic abnormalities, breathing disorders, phonation disorders, reduced speech intelligibility, various physiognomic disorders.
The presented case study emphasizes the need of an interdisciplinary approach to labio-maxillo-palatine clefts and follows the recovery process from a multidisciplinary perspective. The conclusions of the paper support the idea that the recovery process of the child with facio-labio-palatine cleft is a complex, long-termed one and the concern of the speech and language therapist to expand his field of activity is justified because this disorder involves pre and post surgery intervention and the therapist supports the entire process in all the mentioned areas.

Keywords: labio-maxillo-palatine cleft, open rhinolalia, orthodontic devices, speech intelligibility, speech disorder

"/pdfDOI: 10.26744/rrttlc.2021.7.1.04

Published on line: 31/03/2021
Arosarena, O. A. (2007). Cleft lip and palate: Otolaryngologic Clinics of North America, vol. 40, no. 1, pp. 27–60.
Bodea Hațegan, C. (2016). Terapia tulburărilor de limbaj. Structurilor deschise, Ed. Trei, București.
Bjork, A. (2007). Sutural growth of the upper face studied by the implant method: European Journal of Orthodontics i82-i88.
Boyne, P. J., Sands, N. R. (1972). Secondary bone grafting of residual alveolar and palatal clefts, Journal of Oral Surgery, vol. 30, no. 2, pp. 87–92.
Burlibaşa, C. (coord) (1999). Chirurgie orală şi maxilo-facială, (Ed. aII-a), Ed. Medicală, Bucureşti
Hurubeanu, L. (2002). Stomatologie şi chirurgie oro-maxilo-facială, Ed. Medicală a Universităţii „Iuliu Haţieganu”, Cluj-Napoca.
Guţu, M. (1975). Logopedie, Universitatea Babeş-Bolyai, Cluj-Napoca, Uz intern
Katzel, E. B., Basile, P., Koltz, P. F., Marcus, J. R., Girotto, J. A. (2009). Current surgical practices in cleft care: cleft palate repair techniques and postoperative care, Plastic and Reconstructive Surgery: vol. 124, no. 3, pp. 899–900.
Kirschner, R. E., LaRossa, D. (2000). Cleft lip and palate: Otolaryngologic Clinics of North America, vol. 33, no. 6, pp. 1191–1215.
Kuijpers-Jagtman, A. M. (2006). The orthodontist, an essential partner in CLP treatment, B-ENT, vol. 2, no. 4, pp. 57–62.
Levy-Bercowski, D., DeLeon, E. Jr, Stockstill, J. W., Yu, J. C. (2011). Orthognathic cleft-surgical/orthodontic treatment, Seminars in Orthodontics, vol. 17, no. 3, pp. 197–206.
Meazzini, M.C. (2008). A Cephalometric Intercenter Comparison of Patients With Unilateral Cleft Lip and Palate: Analysis at 5 and 10 Years of Age and Long Term, The Cleft Palate-Craniofacial Journal 45(6):654-60
Mercado, A., Vig, K. (2019). Orthodontic Principles in the Management of Orofacial Clefts
Miloro, M., Larsen, P., Ghali, G. E. (2004). WaitePeterson’s Principles of Oral and Maxillofacial Surgery:BC Decker, Ontario, Canada, 2 edition 2004.
Moldovan, I. (2006). Corectarea tulburărilor limbajului oral, Presa universitară clujeană, Cluj Napoca
Mureșan, R. (2015). Anatomia cavității bucale. Recuperarea disfagiei, note de curs
Salyer, K. E. (2001). Excellence in cleft lip and palate treatment, Journal of Craniofacial Surgery, vol. 12, no. 1, pp. 2–5.
Saperstein, E.L., Kennedy, D., Muliken, J.B., Padwa B., (2012).Facial growth in children with complete cleft of the primary palate and intact secondary palate: Oral Maxillofacial Journal 70:e66-e71.
Shaikh, D., Mercer, N. S., Sohan, K., Kyle, P., Soothill, P., (2001). Prenatal diagnosis of cleft lip and palate: British Journal of Plastic Surgery, vol. 54, no. 4, pp. 288–289.
Shetye, P. R., (2012). Presurgical infant orthopedics, The Journal of Craniofacial Surgery, vol. 23, no. 1, pp. 210–211.
Tote, R., Munteanu, S., Pascu, A., Purav, D., Stancu, D., Oruc, V., Komini, E., Melian, G., Zetu, I., (2014). Aspecte clinico-terapeutice ale despicăturilor labio-maxilo-palatine: date din lieratură, Romanian Journal of Medical and Dental Education, vol.3, issue 1, January-June 2014.
Vlachos, C. C. (1996). Orthodontic treatment for the cleft palate patient, Seminars in Orthodontics, vol. 2, no. 3, pp.197–204.
Wyszynski, D.F. (2002). Cleft Lip and Palate: From Origin to Treatment: Oxford University Press.

Reabilitarea preoperatorie sau pregatirea fizica inainte de operatie



Rinolalia deschisă în context sindromic și non-sindromic

Rinolalia deschisă în context sindromic și non-sindromic

Rhinolalia aperta in a syndromic and non-syndromic context


This article describes the results obtained in a research which study the symptomatology of open rhinolalia in syndromic and non-syndromic context.
Open rhinolalia represents a real, complex, less common problem with major implications for language development, both organic and functional, and whose diagnosis, evaluation and intervention approach is poorly known and adopted in speech therapy practice.
The approach in the research of both the specifics of non-syndromic rhinolalia and syndromic rhinolalia aims at identifying the particularities and symptoms of this speech disorder and focuses mainly on the identification of the degree of development of expressive language and the intelligibility of speech, but also on finding the level and the type of the associated voice disorder and the similarities and differences between the specificity of non-syndromic rhinolalia and syndromic rhinolalia. In the case of syndromic rhinolalia, it has been observed how optimal development and rehabilitation of language is influenced by association with Down syndrome and Pierre-Robin syndrome.

Keywords: open rhinolalia, non-syndromic rhinolalia, syndromic rhinolalia, voice disorder, speech disorder, speech intelligibility

DOI: 10.26744/rrttlc.2017.3.2.07

Published on line: 31/10/2017


Anca, M., Bodea Hațegan, C., Talaș, D. (2013). Pierre-Robin Syndrome: A Romanian Psycho-Pedagogical Case Report, Procedia- Social abd Behavioral Science, Volumul 78, 13 mai 2013, 245-249.

Băndilă, A., Rusu, C. (1999). Handicap și readaptare- Dicționar Selectiv : Psihopedagogie Specială. Defectologie medico-socială, București: Editura Pro Humanitate.

Bodea Hațegan, C. (2016). Logopedia.Terapia tulburărilor de limbaj. Structuri deschise, Cluj-Napoca: Editura Trei, 240-274.

Buckley, S. (1999). Improving the Speech and Language Skills of Children and Teenagers with Down Syndrome, Down Syndrome News and Update, Volumul I, Nr. 3, 111-128. Accesat în data de 18 februarie 2017, online la

Crowley, L., Gist, K. L., Gregson, K. M., Hufnagle, K., Peterson Falzone, S., Smythe, C. N., Trivelpiece, R. (2010). Your Baby`s First Year, Cleft Palate Foundation, Chapel Hill, Carolina de Nord. Accesat în data de online la 9 noiembrie 2016, online la

Evans, K. N. et al. (2011). Robin Sequence: From Diagnosis to Development of an Effective Management Plan, State- of- the- art review articles, American Academy of Pediatrics, Seattle. Accesat în data de 17 martie 2017, online lațu, M. (1974). Curs delogopedie.curs litografiat, Cluj-Napoca: Universitatea Babeș-Bolyai.

Kummer, W. A., Lee, L. (1996). Evaluation and Treatment of Resonance Disorders, Language, Speech, and Hearing Services in Schools, American Speech-Language-Hearing Association, Volumul 27, Iulie, 271-281.

Maftei, I., Chirilă, I. (2001). Malformații congenitale ale feței și maxilarelor. În Bulibașa,C. (2001). Chirurgie orală și maxilofacială,ediția a II-a, București: Editura Medicală.

Moldovan, I. (2006). Corectarea tulburărilor limbajului oral, Cluj-Napoca: Presa Universitară Clujeană.

Peterson-Falzone, S.J., Trost-Cardamone, J.E., Karnell, M.P., Hardin-Jones, M.A. (2006). The Clinician`s Guide to Treating Cleft Palate Speech, Missouri: Mosby Inc.

Roberts, J. E., Price, J., Malkin, C. (2007). Language and Communication Development in Down Syndrome,Mental Retardation and Developmental Disabilities Reserch Reviews, Volumul XIII, 26-35. Accesat în data de 25 martie 2017, online la

Tote, R. et al. (2014). Aspecte Clinico-Terapeutice ale Despicăturilor Labio-Maxilo-Palatine: Date din Literatură,Romanian Journal of Medical and Dental Education, Volumul 3, Ianuarie-Iunie, 57-62. Accesat în data de 20 octombrie 2016, online laĂTURILOR-LABIO-MAXILO-PALATINE-DATE-DIN-LITERATURĂ.pdf


Therapeutic valences for spectrographic method

Valenţe corectiv compensatorii ale metodei spectografice

Therapeutic valences for spectrographic method

Alina BOCA

The speech intelligibility degree of the hearing impaired children speech varies widely, from completely incomprehensible to almost functional. Although a number of studies have documented typical speech disorders of the hearing impaired children compared with hearing children.
Most of these studies have been limited to the analysis of perceptual errors of type phonetic and phonological. In recent years of the digital technology has greatly increased the efficiency of speech acoustics study, which may provide more precise details than perceptual analysis regarding timing and frequency distribution of acoustic energy into individual segments of speech

Keywords: speech intelligibility, spectogram, voice onset time, hearing impairments

DOI: 10.26744/rrttlc.2016.2.1.09

Published on line: 15/03/2016


Constantinescu, F. (1964). Contribuţii la fundamentarea ştiintifică a audiometriei vocale. Probleme de defectologie, EDP, Bucureşti

Culbertson, D.N. & Kricos, P.B. (2002) Language and speech of the deaf and hard of hearing. In R.L. Schow & M.A. Ling (Eds.), Introduction to Audiologic Rehabilitation (4th Ed.) (pp.183-224). Boston: Allyn and Bacon.

Davenport, M., & Hannahs, S. J. (1998). Introducing phonetics & phonology. Oxford University Press Inc., New York.

Dodd, B. (1976). The phonological systems of deaf children. Journal of Speech and Hearing Disorders, 41(2), 185-197.

Dunn, C & Newton, L. (1986). A comprehensive model for speech development in hearing impaired children. Topics in Language Disorders, 6(3), 25-46.

Hudgins, C. & Numbers, F. (1942). An investigation of the intelligibility of the speech of deaf and normal subjects. Genetic Psychology Monographs, 25, 286-392.

Ling, D.L. (1976). Speech and the Hearing-Impaired Child: Theory and Practice. Washington: Alexander Graham Bell Association for the Deaf. Ling, D. (1989). Foundations of spoken language for hearing-impaired children. Washington:Alexander Graham Bell Association for the Deaf.

Liberman, P., & Blumstein, S. E. (1988). Speech physiology, speech perception, and acoustic phonetics. Cambridge: Cambridge University Press.

Lisker, Leigh and Arthur Abramson. 1964. A cross-language study of voicing in initial stops: Acoustical measurements. Word 20(3).527-565. Reprinted, with permission from John R. Costello, Editor, WORD.

Smith, B.L. (1982). Some observations concerning pre-meaningful vocalisation of hearing impaired infants. Journal of Speech and Hearing Disorders, 47, 439-441.

Uchanski, R.M. & Geers, A.E. (2003). Acoustic characteristics of the speech of young cochlear implant users: A comparison with normal-hearing age-mates. Ear and Hearing, 24(1S), 90S-105S.

Zemlin, W. R. (1998). Articulation. In W. R. Zemlin (Eds.), Speech and Hearing science (p197-230). Boston: Allyn and Bacon.

Speech intelligibility in the context of hearing impairments

Aspecte ale inteligibilităţii vorbirii la copiii cu dizabilități auditive

Speech intelligibility in the context of hearing impairments

Liana Angela (ROȘCA) MUŞUŢAN

Speech intelligibility of people with hearing disability, who are using a conventional or digital hearing aid or a cochlear implant, is an essential factor that interferes in the communication process with people with normal hearing. Without being understood oral language cannot be an efficient and safe way in the communication process, and in this case, the language cannot exercise its primary function of communication.
The current study aims to highlight the degree of development of speech intelligibility for students with hearing disability who are using digital hearing aids and those with cochlear implants. Recordings were made with students reading lists of words and sentences, witch played to three inexperienced listeners that had to write down (transcription) the words correctly perceived from the students reading. To establish the speech intelligibility, has been applied The Speech Intelligibility Rating Scale (SIR).
The main reason for the selection of this topic is to show that speech intelligibility of children with digital hearing aids and cochlear implant is influenced by many factors that have an impact on oral language development. Among them there are: the type of hearing aid used, the degree of hearing loss, the communication mode used, the beginning of intervention for recovery. Speech intelligibility of students with hearing disability can be improved by applying appropriate strategies and individualized recovery.

Keywords: hearing impairment, speech intelligibility, cochlear implant, hearing aids, speech and language, auditory-verbal therapy

DOI: 10.26744/rrttlc.2016.2.1.11

Published on line: 15/03/2016



Anca, M.(2000). Intervenţii psihopedagogice în antrenarea funcţilor auditiv verbale, Cluj-Napoca: Presa Universitară Clujeană.

Anca, M.  (2001). Psihologia deficienţilor de auz,  Cluj-Napoca: Presa Universitară Clujeană, Cluj-Napoca.

Anca, M. (2010). Criterii și metode utilizate în evaluarea copiilor cu implant cohlear  în Dinamica educaţiei speciale, Cluj-Napoca: Presa Universitară Clujeană.

Bernstein, L.E.,Goldstein, M.H., Mahshie, J. J. (1988). Speech training aids for hearing-impaired individuals, Journal of Rehabilitation Research and Development, Vol . 25,  No .4.

Bodea Hațegan, C. (2015). Dizabilitățile auditive, în Roșan, A. (2015). Psihopedagogia specială. Modele de evaluare și intervenție, Iași: Polirom, p. 124-151.

Bodea Haţegan, C. (2013). Tulburări de voce și vorbire. Evaluare și intervenţie. Presa Universitară Clujeană, Cluj-Napoca.

Haţegan, C. (2010). Repere psihopedagogice ale terapiei auditiv-verbale în condiţiile implantării cohleare, în Dinamica educaţiei  speciale,  Cluj-Napoca: Presa Universitară Clujeană.

Hodge, M., Whitehill, T. (2010). Intelligibility Impairments,  The Handbook of Language and Speech Disorders,  United Kingdom: Wiley – Blackwell Publishing, disponibil pe:

Markides, A. (1983),  The Speech of hearing-impaired children, Manchester: Manchester University Press disponibil pe:

Osberger, M. J. (1992), Speech Intelligibility in the hearing-impaired: research and clinical implication, în Raymond D. K (1992). Intelligibility in Speech Disorder, Amsterdam: John Benjamin Publishing.