PE2876 Upper Jaw Surgery and Speech

Upper Jaw Surgery and Speech

Surgery to the upper jaw can lead to possible changes in your child’s speech.

Upper jaw (maxilla) surgery realigns the jaw by moving the bone of the roof of the mouth forward. We may do jaw surgery to improve how the teeth align or to treat sleep apnea. We move the bone forward by making a cut (incision) on the inside of the upper lip, separating the upper jaw from the skull. We then move the upper jaw forward and hold it in the new position with plates and screws. Some children need to wear hardware (called distraction) to help move the bones forward. Some children may need surgery on both upper and lower jaws.

How can jaw surgery When your child’s upper jaw is moved forward by surgery, it may impact impact my child’s their speech in 2 ways. speech?

Velopharyngeal First, surgery may impact whether air escapes through your child’s nose Insufficiency (VPI) when they talk.

In surgery, the jaw This movement bone attached to can prevent the the palate is moved palate from forward reaching the back of the throat

A closed soft palate with A slightly open soft palate airflow through the mouth. with airflow through the nose and mouth.

In normal speech, the soft tissue at the back of the roof of the mouth (or soft palate) closes against the back of the throat to keep air from coming out of the nose. A closed palate allows us to easily make sounds such as P, B, T, D, K, G, S, Z, F, V, SH, CH, DG and TH. If the palate does not close all the way, air escapes out of the nose on these sounds, so they sound different.

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To Learn More Free Interpreter Services • Craniofacial Center • In the hospital, ask your nurse. 206-987-2208 • From outside the hospital, call the • Oral and Maxillofacial Surgery Center toll-free Family Interpreting Line, 206-987-2243 1-866-583-1527. Tell the interpreter • Ask your child’s healthcare provider the name or extension you need. • seattlechildrens.org

Upper Jaw Surgery and Speech

The soft palate connects to the bony upper jaw. When the upper jaw moves forward, the soft palate moves forward as well. Sometimes, this movement means the soft palate does not reach all the way to the back wall of the throat and air escapes out the nose. This is called Velopharyngeal Insufficiency (VPI). In some children, VPI lasts a short time and gets better within a few weeks or months after surgery. In other children, air continues to escape out of the nose even after a few months. If this happens, we can evaluate whether another surgery may be needed to treat VPI. We recommend a speech evaluation in the year before your child's surgery to assess their risk of developing VPI. You should return for a craniofacial speech evaluation 3 months after surgery to see if your child has any other speech needs.

Articulation Surgery can also impact how your child creates certain speech sounds (this is called articulation). When the upper jaw is behind the lower teeth, it can be hard to get the tongue in the correct place when saying T, D, N and S. It can also be hard to use the lips correctly to say F and V. Some children say that their speech sounds “slushy” before surgery because of this. Once we align the upper and lower jaws, it often becomes easier to say these sounds the right way.

What if I have Contact the Seattle Children's Craniofacial Center at 206-987-2208 or the questions? Oral and Maxillofacial Surgery Center at 206-987-2243.

Seattle Children’s offers interpreter services for Deaf, hard of hearing or non-English speaking patients, family members and legal representatives free of charge. Seattle Children’s will make this information available in alternate formats upon request. Call the 8/21 Family Resource Center at 206-987-2201. This handout has been reviewed by clinical staff at Seattle Children’s. However, your child’s PE2876 needs are unique. Before you act or rely upon this information, please talk with your child’s healthcare provider.

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