Orofacial Clefting: Impact on Speech, Breathing and Sleep • HRB4099

*Disciplina ministrada em língua inglesa 



Ana Paula Fukushiro

Inge Elly Kiemle Trindade

Ivy Kiemle Trindade Suedam





(per week)
(per week)
(per week)
Duration Total
8h 4h 3h 3 weeks 45h


To study the speech, breathing and sleep disorders associated to orofacial clefts and related anomalies.



Orofacial clefts may affect speech, breathing and sleep, and the surgical treatment may further compromise those functions.

Therefore, the functional disorders related to clefting are discussed along with the advances of instrumental diagnosis and therapy interventions, and the benefits and disavantages of the primary and secondary treatment modalities. 



Speech, breathing and sleep physiology. 
The impact of orofacial clefts on speech, breathing and sleep. 
Dysfunctions/deformities secondary to orofacial clefts: velopharyngeal dysfunction, nasal obstruction, dental-skeletical abnormalities, obstructive sleep apnea and others. 
Instrumental assessment by nasometry, aerodynamic technique, nasopharyngoscopy, videofluoroscopy, rhinomanometry, acoustic rhinometry, polysomnography, 3D technology, computational fluid dynamics. 
The functional effects of reconstructive surgeries of cleft lip and palate and related deformities. 
Speech, breathing and sleep intervention strategies. 
Institutional outcomes. 



Campos LD, Trindade-Suedam IK, Sampaio-Teixeira AC, Yamashita RP, Lauris JR, Lorenzi-Filho G, et al. Obstructive sleep apnea following pharyngeal flap surgery for velopharyngeal insufficiency: a prospective polysomnographic and aerodynamic study in middle-aged adults. Cleft Palate Craniofac J. 2016;53(3):e53-9

de Sousa TV, Marques IL, Carneiro AF, Bettiol H, Freitas JA. Nasopharyngoscopy in Robin sequence: clinical and predictive value. Cleft Palate Craniofac J. 2003;40(6):618-23

Freitas JA, Trindade-Suedam IK, Garib DG, Neves LT, Almeida AL, Yaedú RY, et al. Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) – Part 5: institutional outcomes assessment and the role of the Laboratory of Physiology. J Appl Oral Sci. 2013;21(4):383-90

Fukushiro AP, Trindade IE. Nasal airway dimensions of adults with cleft lip and palate: differences among cleft types. Cleft Palate Craniofac J. 2005;42(4):396-402

Fukushiro AP, Trindade IE. Nasometric and aerodynamic outcome analysis of pharyngeal flap surgery for the management of velopharyngeal insufficiency. J Craniofac Surg. 2011;22(5):1647-51

Pinheiro ML, Yatabe M, Ioshida M, Orlandi L, Dumast P, Trindade-Suedam IK. Volumetric reconstruction and determination of minimum crossectional area of the pharynx in patients with cleft lip and palate: comparison between two different softwares. J Appl Oral Sci. 2018;26:e20170282

Prado P, Fernandes M, Trettene A, Salgueiro AG, Trindade-Suedam IK, Trindade, IEK. Surgical closure of the cleft palate causes a transient obstructive effect on upper airway in children. Cleft Palate Craniofac J. (PRINT)

Sampaio-Teixeira ACM, Oliveira DN, Yamashita RP, Fukushiro AP, Trindade IEK. Normative nasalance scores in the production of words and syllables for Brazilian Portuguese speakers. Clin Linguist Phon. 2019:1-10

Trindade IE, Araújo BM, Teixeira AC, Silva AS, Trindade-Suedam IK. Velar activity in individuals with velopharyngeal insufficiency assessed by acoustic rhinometry. J Appl Oral Sci. 2014;22(4):323-30

Trindade IE, Bertier CE, Sampaio-Teixeira AC. Objective assessment of internal nasal dimensions and speech resonance in individuals with repaired unilateral cleft lip and palate after rhinoseptoplasty. J Craniofac Surg. 2009;20(2):308-14

Trindade IE, Castilho RL, Sampaio-Teixeira AC, Trindade-Suedam IK, Silva-Filho OG. Effects of orthopedic rapid maxillary expansion on internal nasal dimensions in children with cleft lip and palate assessed by acoustic rhinometry. J Craniofac Surg. 2010;21(2):306-11

Trindade IE, Gomes AeO, Fernandes MeB, Trindade SH, Silva Filho OG. Nasal airway dimensions of children with repaired unilateral cleft lip and palate. Cleft Palate Craniofac J. 2015;52(5):512-6

Trindade IE, Yamashita RP, Suguimoto RM, Mazzottini R, Trindade AS. Effects of orthognathic surgery on speech and breathing of subjects with cleft lip and palate: acoustic and aerodynamic assessment. Cleft Palate Craniofac J. 2003;40(1):54-64

Trindade SHK, Tagliarini JV, Trindade IEK, Weber SAT. Nasal septoplasty in patients with obstructive sleep apnea syndrome: effects on polysomnographic parameters. Journal of Sleep Medicine and Disorders. 2017;4:1

Trindade-Suedam IK, Castilho RL, Sampaio-Teixeira AC, Araújo BM, Fukushiro AP, Campos LD, et al. Rapid maxillary expansion increases internal nasal dimensions of children with bilateral cleft lip and palate. Cleft Palate Craniofac J. 2016;53(3):272-7

Trindade-Suedam IK, Lima TF, Campos LD, Yaedú RYF, Filho HN, Trindade IEK. Tomographic pharyngeal dimensions in individuals with unilateral cleft lip/palate and class III malocclusion are reduced when compared with controls. Cleft Palate Craniofac J. 2017;54(5):502-8

Yamashita RP, Borg E, Granqvist S, Lohmander A. Reliability of hypernasality rating: comparison of 3 different methods for perceptual assessment. Cleft Palate Craniofac J. 2018:1055665618767116

Yamashita RP, Trindade IE. Long-term effects of pharyngeal flaps on the upper airways of subjects with velopharyngeal insufficiency. Cleft Palate Craniofac J. 2008;45(4):364-70

Yatabe-Ioshida MS, Campos LD, Yaedu RY, Trindade-Suedam IK. Upper airway 3D changes of patients with cleft lip and palate after orthognathic surgery. Cleft Palate Craniofac J. 2019;56(3):314-20



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