SLPSystematic ReviewAmerican journal of speech-language pathology2024

Characterizing Speech Phenotype in Individuals With Craniofacial Microsomia: A Scoping Review.

Sara Kinter, Katelyn Kotlarek, Anna Meehan and 1 others

PMID 37931079

WHAT IT FOUND

Speech issues in craniofacial microsomia are common but inconsistently measured.

Hypernasality and articulation errors are the most reported problems, yet prevalence varies widely across studies. Routine speech evaluation is recommended, though evidence for specific interventions remains limited.

Key findings

01Hypernasality and velopharyngeal insufficiency are the most commonly reported speech findings, affecting up to 55% of individuals across studies, though measurement methods varied considerably.

02Articulation errors, particularly oral distortions of fricatives and affricates, were the second most common issue, with adolescents showing lower intelligibility than peers.

03The literature lacks consistent definitions and measurement of speech, preventing conclusions about overall prevalence or risk factors across subgroups.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The majority of included studies were case reports or case series, which cannot establish prevalence or causality. Definitions and measurement tools for speech outcomes varied widely across studies, preventing meta-analysis or consistent comparison. Studies relying on chart review may overestimate VPI prevalence due to referral bias (only those with concerns are evaluated). Hearing loss was excluded as a primary focus, yet it may confound articulation outcomes in this population. No studies directly measured respiratory support for speech, leaving a gap in understanding breath support issues.

Declared interests

The authors declared no conflicts of interest. The research was supported by NIH grants, and the REDCap database was supported by the National Center for Advancing Translational Sciences.

The easy way to misread this

Do not interpret the 'up to 55%' VPI prevalence as a definitive rate for all patients with CFM. This figure aggregates data from studies with vastly different definitions, measurement methods, and patient subgroups, so it reflects the variability in the literature rather than a consistent clinical reality.

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