Cleft Palates, Crouzon Syndrome & Curta Curtitiba
A group of 15 UW-Stevens Point speech-language pathology graduate students are on a 12-day trip to the Center for Cleft Lip and Palate Care (CAIF) in Curitiba, Brazil.
By Pam Terrell, Ph.D.
Today we all stayed together in one big group as we watched 11 nasoendoscopies to assess velopharyngeal function (where the soft palate should come in contact with the back of the throat during speech). The nasoendoscopy team at CAIF is composed of the speech pathologist, ENT, psychologist, and prosthodontist. This is very different from the US. In the US, usually an SLP or an ENT does the nasoendoscopy. Here it is a whole team–the more brains and eyes, the better! The psychologist prepares the patient for the procedure and explains the process. The ENT passes the tube through the nose and just above the velopharyngeal sphincter muscles. The SLP and ENT consult together to watch for muscle movement during various speech tasks. The SLP decides if the palate is the correct length and if the muscles are working properly. If not, she then determines whether the patient needs surgery, a prosthesis, speech therapy, or a combination of treatments. If a prosthetic device is used, the prosthodontist make appropriate fittings and adjustments. The patients we saw ranged from young children to senior adults. Most of the patients had clefts, but two of them had velopharyngeal incompetence due to neurological causes, car accident and encephalitis. The students also saw two pharyngeal flaps.
In the afternoon, the students rotated between the orthodontist, the oral-maxillofacial surgeon, and the prosthodontist. They got to see a patient with Crouzon Syndrome, a rare syndrome that they had studied in class. They also saw a 60+ year-old man who never had his palate closed and was wearing a special prosthesis called an obturator. Additionally, they saw many interesting patients with complicated orthodontics and follow-up oral surgery appointments. In the afternoon, we had lectures from the orthodontist and prosthodontist.
Today was the first day that we left the clinic before dark. It was a shock to still see sunlight when we got on the bus. After dropping our things off at the hotel, most of us walked about four blocks to a festival in the city center. We ran into one of the hotel workers there who recognized us. It was so funny to see someone we “knew” in the middle of a foreign city of almost 2 million people. The festival was very crowded and full of handmade crafts and international foods. The atmosphere was very fun and we had fun stopping to look at all of the crafts. Tonight, handmade scarves were the favorite shopping purchase. As we walked back to the hotel we also stopped by a small grocery store and bought coffee and chocolate to bring home.
Tomorrow will be another busy day and then we will be at a samba club until late tomorrow night, so I don’t know if I will have time to write or post pictures again until we arrive back in the US. So far it has been a great experience all around! It’s so nice to get to know the students outside of the classroom and to share with them the people and the country I have grown to love.