The Role of the Velopharyngeal Sphincter in the Speech of Patients with Cleft Palate or Cleft Lip and Palate Using Perceptual Methods
DOI:
https://doi.org/10.3889/oamjms.2016.137Keywords:
cleft palate, velopharyngeal sphincter, velopharyngeal dysfunction, Czermak mirror fogging test, PWSSAbstract
BACKGROUND: The velopharyngeal sphincter (VPS) plays the main role in speech formation. The cleft palate, due to the damage of the soft palate, leads to dysfunction of the velopharyngeal sphincter thus causing speech disorder.
AIM: To establish a link between the nasal air escape and the perceptual symptoms in the speech of patients with cleft palate or cleft lip and palate using auditory-visual perceptual procedures for determining the influence the velopharyngeal dysfunction has on speech.
MATERIAL AND METHODS: Twenty patients with speech disorders, out of which 10 have cleft palate or cleft lip and palate (experimental group), participated in the perceptual assessment by means of Czermak mirror fogging test for assessing the nasal air escape and Pittsburgh Weighted Speech Scale (PWSS) for assessing the probable nature of the velopharyngeal sphincter.
RESULTS: The respondents with a considerable nasal air escape have a higher velopharyngeal inability, that is, probably incompetent nature of the velopharyngeal sphincter. There is a strong correlation between the nasal air escape and the probable nature of the velopharyngeal sphincter (the coefficient of linear correlation r = 0.9756). The calculated р-value is р = 0.000002.
CONCLUSION: The perceptual speech symptoms and the nasal air escape provide unique insight into the state and role the velopharyngeal sphincter has in speech.Downloads
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References
De Bodt M, Van Lierde K. Cleft palate speech and velopharyngeal dysfunction: the approach of the speech therapist. B-ENT. 2006;2(Suppl. 4):63-70. PMid:17366850
Dudas JR et al. Diagnosis and treatment of velopharyngeal insufficiency: Clinical utility of speech evaluation and videofluoroscopy. Ann Plast Surg. 2006; 56: 511-7. https://doi.org/10.1097/01.sap.0000210628.18395.de PMid:16641626 DOI: https://doi.org/10.1097/01.sap.0000210628.18395.de
Maryn Y, De Bodt M, Willockx V, Van Lierde KM. Velofaryngale stoornissen. Terminologie en logopedische protocollering. Logopedie. 1999;2:21-36
Trost-Cardamone JE. Coming to terms with VPI: a response to Loney and Bloem. Cleft Palate J. 1989;26:68-70. PMid:2645070
Marsh JL. Management of velopharyngeal dysfunction: differential diagnosis for differential management. J Craniofac Surg. 2003;14:621– 8. https://doi.org/10.1097/00001665-200309000-00004 PMid:14501319 DOI: https://doi.org/10.1097/00001665-200309000-00004
Marsh JL. The evaluation and management of velopharyngeal dysfunction. Clin Plast Surg. 2004;31:261-269. https://doi.org/10.1016/S0094-1298(03)00124-X DOI: https://doi.org/10.1016/S0094-1298(03)00124-X
Kummer AW, Clark SL, Redle EE, Thomsen LL, Billmire DA. Current practice in assessing and reporting speech outcomes of cleft palate and velopharyngeal surgery: a survey of cleft palate/craniofacial professionals. Cleft Palate Craniofac J. 2012;49(2):146-52. https://doi.org/10.1597/10-285 PMid:21501067 DOI: https://doi.org/10.1597/10-285
Youssefa G, Alkhajab A. The role of auditory perceptual analysis of speech in predicting velopharyngeal gap size in children with velopharyngeal insufficiency. The Egyptian Journal of Otolaryngology. 2015;31:122–127. https://doi.org/10.4103/1012-5574.156097 DOI: https://doi.org/10.4103/1012-5574.156097
Rudnick EF, Sie KC. Velopharyngeal insufficiency: current concepts in diagnosis and management. Curr Opin Otolaryngol Head Neck Surg 2008 Dec; 16(6): 530-5. https://doi.org/10.1097/MOO.0b013e328316bd68 PMid:19005324 DOI: https://doi.org/10.1097/MOO.0b013e328316bd68
Van Lierde KM, Van Borsel J, Moerman M, Van Cauwenberge P. Nasalance, nasality, voice, and articulation after uvulopalatopharyngoplasty. Laryngoscope 2002; 112(5): 873-8. https://doi.org/10.1097/00005537-200205000-00018 PMid:12150621 DOI: https://doi.org/10.1097/00005537-200205000-00018
Gubrynowicz R, Chojnacka-Wadolowska D, Konopka C. Assessment of velum malfunction in children through simultaneous nasal and oral acoustic signals measurements. Archives of acoustics. 2007; 32(1):165-175.
Paniagua, Lauren Medeiros et al. Velopharyngeal Dysfunction: A Systematic Review of Major Instrumental and Auditory-Perceptual Assessments. International Archives of Otorhinolaryngology. 2013;17(3): 251–256. PMid:25992022 PMCid:PMC4423245 DOI: https://doi.org/10.7162/S1809-97772013000300004
McWilliams BJ, Phillips BJ. Velopharyngeal Incompetence: Audio Seminars in Speech Pathology. Philadelphia: W.B. Saunders, Inc., 1979.
Gart MS, Gosain AK. Diagnosis and management of velopharyngeal insufficiency following cleft palate repair. J Cleft Lip Palate Craniofac Anomal. 2014;1:4-10. https://doi.org/10.4103/2348-2125.126536 DOI: https://doi.org/10.4103/2348-2125.126536
Prathanee B. Cleft Palate-Speech Evaluation. International Encyclopedia of Rehabilitation Web site: http://cirrie.buffalo.edu/encyclopedia/en/article/261/. Accessed November 2, 2016.
Christopher JH, Mark EB. Diagnosis and treatment of velopharyngeal insufficiency. Clinical Management of Children's Voice Disorders. Plural Publishing, 2010:231-232.
Lipira AB, Grames LM, Molter D, Govier D, Kane AA, Woo AS. Videofluoroscopic and nasendoscopic correlates of speech in velopharyngeal dysfunction. Cleft Palate Craniofac J. 2011;48(5):550-60. https://doi.org/10.1597/09-203 PMid:20815707 DOI: https://doi.org/10.1597/09-203
Chow et al. Validation of the Mirror-Fogging Test for Velopharyngeal Insufficiency. The Open Otorhinolaryngology Journal. 2015;8: 15-21.
Vander Poorten V et al. The Leuven staged supraperiosteal retropositioning repair: long-term velopharyngeal function in non-syndromic cleft palate. B-ENT. 2006;2(Suppl.4):35-43. PMid:17366846
StatSoft, Inc. STATISTICA (data analysis software system), version 7.1., 2005. www.statsoft.com
Scarmagnani RH, Barbosa DA, Fukushiro AP, Salgado MH, Trindade IE, Yamashita RP. Relationship between velopharyngeal closure, hypernasality, nasal air emission and nasal rustle in subjects with repaired cleft palate. Codas. 2015;27(3):267-72. https://doi.org/10.1590/2317-1782/20152014145 PMid:26222944 DOI: https://doi.org/10.1590/2317-1782/20152014145
Kummer AW, Curtis C, Wiggs M, Lee L, Strife JL. Comparison of velopharyngeal gap size in patients with hypernasality, hypernasality and nasal emission, or nasal turbulence (rustle) as the primary speech characteristic. The Cleft palate-craniofacial journal. 1992;29(2):152-6. https://doi.org/10.1597/1545-1569(1992)029<0152:COVGSI>2.3.CO;2 DOI: https://doi.org/10.1597/1545-1569(1992)029<0152:COVGSI>2.3.CO;2
Abou-Elsaad et al. Videofluoroscopic assessment of velo-pharyngeal port. J Otolaryngol Head Neck Surg 2006; 135:118. http://dx.doi.org/10.1016/j.otohns.2006.06.793 DOI: https://doi.org/10.1016/j.otohns.2006.06.793
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