Medical-Ese As A Second Language

By Joanne Green

Any person that has ever traveled to any extent has learned first hand how important it is that you understand, and even speak, the language of the people around you. It is no different now. You have entered a new world, so to speak, that has a language all its own. Your cleft-affected child has exposed you to a world that speaks, as its primary language, Medical-ese. Doctors and medical staff speak it fluently and that many times forget that you may not yet be proficient in their language. It's not that they are trying to impress you. Actually, they have grown so used to using the words of this strange language that the words that the words of their mother tongue seem to them to be self evident. So to even things out a bit, we are printing a small very-much-abridged version of a Cleft/English dictionary.

The bottom line, however is this: If you don't know what your doctor is telling you, ask him to explain. He wants you to understand or he wouldn't give you the information in the first place. If you don't ask him to clarify when you don't understand him, he has no way of knowing when he lost you

. ***** CLEFT MINI-DICTIONARY *****

ABBE FLAP - An operation in which some of the lower lip tissue is transferred to the repaired upper lip in order to achieve a fuller upper lip area. It is usually done when the upper lip repair is too tight.
ALAR CARTILAGE - The cartilage that forms the tip of the nose and the nostrils. ALVEOLAR COLLAPSE - The condition in which one or both sides of the upper gum move to the center, behind the premaxilla, disrupting the normal dental arch.
ALVEOLUS (Alveolar Process, Alveolar Ridge) - The part of the bony upper jaw that contains teeth (the upper gum).
ARCH (Dental Arch) - The horseshoe shape of the upper gum.
ARTICULATION - The process of forming speech sounds.
AUDIOGRAM - A hearing test.
AUTOGENOUS BONE - Bone transplant material that is harvested from the patient's own body.
BILATERAL CLEFT LIP - A cleft that occurs on both sides of the lip.
CANCELLOUS BONE - Bone marrow material used in bone graft surgery. CHEILOPLASTY - Surgery to close a cleft lip.
CLEFT - A split or opening (in the lip or palate or both).
COLUMELLA - The outer portion of the nose that divides the nostrils.
COMPLETE CLEFT - A cleft that extends through the entire affected mouth structure. DECIDUOUS TEETH (Primary, Baby Teeth) - The teeth that are expected to come out as a part of normal development.
EUSTACHIAN TUBE - The tube that connects the middle ear to the back of the throat. FISTULA - An abnormal reopening occurring after surgical repair of the palate. HYPERNASALITY (Nasality) - Greater than normal nasal resonance during speech. INCISIVE FORAMEN - The point that divides the primary palate (lip and gum) from the secondary palate (hard and soft palates).
INTERDISCIPLINARY APPROACH - A method of treating cleft lip and palate in which several medical, dental, speech, and hearing specialists work together, coordinating their efforts and planning a coordinated treatment.
LARYNX - A structure located at the top of the trachea that produces sound; the voice box. LATERAL MAXILLARY SEGMENTS - The two side segments of the bony upper jaw, or upper gum ridge.
LEVATOR MUSCLES - Muscles the lift or elevate, such as those found in the soft palate. MALOCCLUSION - A poor relationship of the upper teeth to the lower teeth during bite. MANDIBLE - The lower jaw (chin).
MAXILLA - The bony upper jaw.
MAXILLOFACIAL ADVANCEMENT - A procedure in which the maxilla is moved forward in order to achieve a more normal profile of the midface.
MIDLINE CLEFT - A very rare cleft condition in which a cleft occurs in the midline of the face. Most often occurring as a part of some other syndrome.
MIXED DENTITION - The time during which you have some baby teeth and some permanent teeth.
MYRINGOTOMY - A procedure in which a tiny incision is made in the eardrum to allow the release of pressure caused by excess fluid. This procedure is other combined with the insertion of myringotomy tubes.
NASAL ALAE (Ala Nasi) - The wings or sides of the nostril.
NASAL SEPTUM - The internal structure that divides the nasal cavity.
NASOPHARYNX - The area that makes up the back of the throat.
OBTURATOR - A retainer-like device sometimes worn over the cleft of the hard palate to aid in feeding and speech development.
OCCLUSION - The relationship between the upper and lower teeth when they are in contact. ORBICULARIS MUSCLE - The muscle that surrounds the mouth and makes up the upper and lower lips.
OTITIS MEDIA - An inflammation of the middle ear caused by infection, allergy, or improper functioning of the Eustachian tube.
PALATAL LENGTHENING (Palatal pushback) - A surgical procedure in which tissue from the front part of the mouth is moved back to lengthen it.
PALATE - The roof of the mouth, made up of the hard and soft palates.
PALATOPLASTY - The surgical closure of the cleft palate.
PARTIAL CLEFT - A cleft that extends through part of the affected structure. PHARYNGEAL - Relating to the pharynx or back of the throat.
PHARYNGEAL AUGMENTATION - Pieces of tissue or other substances used in the back of the throat to reduce the distance that the soft palate must move to achieve normal closure during speech.
PHARYNGEAL FLAP SURGERY - A procedure in which the surgeon creates a flap of tissue that connects the soft palate to the back wall of the throat to improve closure during speech.
PHILTRUM - The middle of the upper lip located above the vermillion and bordered on either side by soft ridges, or Philtrum lines (the "Cupid's Bow").
PREMAXILLA - The front central section of the upper gum, containing the four upper front teeth.
PRIMARY SURGERY - The initial surgery to repair a cleft lip or palate.
PROLABIUM - The front portion of the upper lip. The prolabium is the detached part of the upper lip in the case of a bilateral cleft lip, often looking like a bubble of flesh.
RESONATORS - Cavities (i.e., mouth, nose, throat) that can be used to change the nature of speech sounds.
SECONDARY ALVEOLAR REPAIR - Bone graft surgery.
SECONDARY SURGERY - Surgery done after primary surgery to improve appearance or to correct additional problems.
SPEECH PROSTHESIS - A device inserted into the mouth to achieve closure and aid in speech.
SUBMUCOUS CLEFT - A cleft affecting the muscles that attach in the middle of the soft palate, but not affecting the skin covering. A submucous cleft is often misdiagnosed because it is not visibly apparent except for a possible tiny cleft of the uvula.
UNILATERAL CLEFT - A cleft that occurs on only the right or left side of the lip.
UVULA - The "punching bag" in the back of the throat.
VELOPHARYNGEAL CLOSURE - Made when the soft palate is raised to contact the back wall of the throat. Closure is necessary for speech, blowing, and swallowing. VELOPHARYNGEAL INSUFFICIENCY - The condition in which the patient is unable to achieve closure between the mouth and nose because of a weakened or inadequately formed structure.
VELUM - The soft palate.
VERMILLION - The dark pink tissue that makes up the lip.

The key here is communication. Regardless of your proficiency - or lack of it - in this new "language", the goal is to understand and to be understood. Don't be afraid to ask for clarification when and if you find your head swimming in a pool of medical-ese. Communication can only occur when what is said is both heard and understood.