Duration of Oral Port Constriction in Normal and Cleft Palate Speech

1968 ◽  
Vol 11 (2) ◽  
pp. 391-401 ◽  
Author(s):  
Donald W. Warren ◽  
Stephen B. Mackler
Keyword(s):  
Cleft Palate ◽  
Normal Subjects ◽  
Acoustic Cues ◽  
Sound Generation ◽  
Cleft Palate Speech ◽  
Velopharyngeal Closure ◽  
Intraoral Pressure ◽  
Closure Group ◽  
Nasal Emission

Duration of constriction, determined from measurements of intraoral pressure, was studied in 25 cleft palate and 20 normal subjects. The cleft palate group consisted of 15 subjects who achieved adequate velopharyngeal closure and 10 subjects who did not. All subjects were able to produce the test consonants intelligibily. Results reveal that the duration of oral port constriction is longest in cleft palate speakers with adequate closure and shortest in normals. It is possible that increasing the duration of constriction may reinforce sound generation and thereby improve consonant perception. The shorter intervals of constriction observed in the inadequate closure group may be due to the increase in nasal emission which presumably results when oral port constriction is prolonged. Within each palate group voiceless fricative consonants exhibited the longest intervals of oral port constriction. This is presumed to be due to the need for sufficient airflow through the oral port in order to provide the necessary acoustic cues for perception of these voiceless sounds.

The Correlation between Nasalance and a Differentiated Perceptual Rating of Speech in Dutch Patients with Velopharyngeal Insufficiency

2002 ◽  
Vol 39 (3) ◽  
pp. 277-284 ◽  
Author(s):  
Kornelis H.D.M. Keuning ◽  
George H. Wieneke ◽  
Hans A. Van Wijngaarden ◽  
Philippe H. Dejonckere
Keyword(s):  
Cleft Palate ◽  
Correlation Coefficients ◽  
University Hospital ◽  
Velopharyngeal Insufficiency ◽  
Visual Analog Scales ◽  
Cleft Palate Speech ◽  
Normal Text ◽  
The Mean ◽  
Lower Correlation ◽  
Nasal Emission

Objective: The correlation between the nasalance score and the perceptual rating of several aspects of speech of speakers with velopharyngeal insufficiency (VPI) by six speech-language pathologists was evaluated. Procedure: The overall grade of severity, hypernasality, audible nasal emission, misarticulations, and intelligibility were rated on visual analog scales. Speech samples with a normal distribution of phonemes (normal text [NT]) and those free of nasal consonants (denasal text [DT]) of 43 patients with VPI were used. Mean nasalance scores were computed for the speech samples, and Spearman correlation coefficients were computed between the mean nasalance score and the five parameters of the differentiated rating. Setting: The Institute of Phoniatrics, Utrecht University Hospital, The Netherlands. Results: The correlation coefficient between the mean nasalance and the perceptual rating of hypernasality ranged among judges from .31 to .56 for NT speech samples and .36 to .60 for DT speech samples. Only small differences were found between speech pathologists with and without expertise in cleft palate speech. The rating of the overall grade of severity appeared to correlate quite well with the rating of the intelligibility (rNT = .77, rDT = .79). Lower correlation coefficients, ranging from .34 to .71, were found between overall grade of severity and hypernasality, audible nasal emission, and mis-articulations. Conclusions: A low correlation between the nasalance and the perceptual rating of hypernasality was found. The parameter overall grade of severity appeared to be determined mainly by the parameter intelligibility. Expertise in rating of cleft palate speech does not guarantee a high correlation between instrumental measurement and perceptual rating.

Intraoral Pressure, Nasal Pressure and Airflow Rate in Cleft Palate Speech

1988 ◽  
Vol 31 (3) ◽  
pp. 432-437 ◽  
Author(s):  
Tellervo Laine ◽  
Donald W. Warren ◽  
Rodger M. Dalston ◽  
W. Michael Hairfield ◽  
Kathleen E. Morr
Keyword(s):  
Cleft Palate ◽  
Upper Airway ◽  
Control Group ◽  
Airflow Rate ◽  
Cleft Palate Speech ◽  
Compensatory Behaviors ◽  
Loss Of Resistance ◽  
Oral Pressure ◽  
Nasal Pressure ◽  
Intraoral Pressure

We have suggested that compensatory behaviors associated with cleft palate may be strategies developed for the purpose of satisfying the requirements of a speech regulating system. The purpose of the present study was to test this hypothesis in subjects demonstrating various degrees of velopharyngeal inadequacy. The pressure-flow technique was used to assess aerodynamic responses to a loss of velar resistance in 74 subjects compared to a control group of 137 subjects with adequate velopharyngeal closure. The results of this study demonstrate that as degree of inadequacy increased, airflow rate also increased. Although intraoral pressure fell as inadequacy increased, many subjects were able to maintain pressures above 3.0 cm H 2 0 by increasing airflow rate. Nasal pressure increased in proportion to the decrease in intraoral pressure While combined nasal plus oral pressure remained constant across groups. These findings suggest that a loss of resistance at the velar port is compensated by an increase in resistance at the nasal port. Airflow rate appears to be adjusted to total upper airway resistance. These findings support our contention that the speech system is constrained to meet aerodynamic requirements.

scholarly journals Nasendoscopic Findings of Velopharyngeal Sphincter in Operated Cleft Palate Patients: Is It Different than Normal Population

2019 ◽  
Vol 52 (02) ◽  
pp. 178-182
Author(s):  
Akangsha Sharma ◽  
Shamendra Anand Sahu ◽  
Karoon Agrawal
Keyword(s):  
Cleft Palate ◽  
Soft Palate ◽  
Normal Population ◽  
Care Center ◽  
Mobile Element ◽  
Normal Subjects ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Complete Closure ◽  
Velopharyngeal Closure

Abstract Objective This study was aimed for nasendoscopic assessment of velopharyngeal sphinteric closure in patients with operated cleft palate and to compare it with normal population. Design A cross-sectional study was done in a tertiary cleft care center in 30 patients with operated cleft palate after a minimum of 6 months of their surgery and 30 randomly selected volunteers with normal speech. Both groups were one-time evaluated by three observers using 70 degree rigid nasendoscope and/or pediatric fiber optic endoscope. Velopharyngeal sphincter closure characteristics in terms of pattern of closure, dominant element involved in the closure, degree of palatal movement, and completeness of the closure were evaluated, recorded, and compared between the groups. Results In both groups, the most common pattern of closure is coronal and soft palate is the dominant mobile element in velopharyngeal closure. All normal subjects showed complete closure of the sphincter with good soft palate movement. But only 50% of the operated patients with cleft showed complete closure and even less than them had good movements of the soft palate. Conclusions Although the pattern of the closure in the operated patients is similar to the normal subjects, the movement of the soft palate and completeness of the velopharyngeal sphincter closure still remain the problem in the operated palate patients.

Hypernasality in the Presence of “Adequate” Velopharyngeal Closure

1993 ◽  
Vol 30 (2) ◽  
pp. 150-154 ◽  
Author(s):  
Donald W. Warren ◽  
Rodger M. Dalston ◽  
Robert Mayo
Keyword(s):  
Cleft Palate ◽  
Aerodynamic Characteristics ◽  
Control Groups ◽  
Pressure Flow ◽  
Instrumental Assessment ◽  
Actual Time ◽  
Velopharyngeal Closure ◽  
Nasal Emission ◽  
Normal Speech ◽  
Nasal Resonance

In some instances, hypernasality occurs despite an instrumental assessment of “adequate” velopharyngeal closure. The pressure-flow technique was used to assess the timing characteristics associated with velopharyngeal closure in 11 such subjects. The group's performance was compared to the aerodynamic characteristics of two other subject groups. One was comprised of 13 cleft palate subjects with adequate closure and normal nasal resonance, while the second group consisted of 16 noncleft subjects who also manifested normal speech. The data indicate that there are several unique timing features that differentiate the hypernasal but “adequate” group from the two control groups. These include a delay of about 50 ms in achieving closure, a longer interval of nasal emission, and a shorter duration of actual closure. Hypernasality seems to be associated with the actual time the velopharyngeal mechanism is open, rather than the volume of air escaping from the nasal chamber.

Submucous Cleft Palate: A Grading System and Review of 40 Consecutive Submucous Cleft Palate Repairs

2004 ◽  
Vol 41 (2) ◽  
pp. 114-123 ◽  
Author(s):  
Brian C. Sommerlad ◽  
Christopher Fenn ◽  
Kim Harland ◽  
Debbie Sell ◽  
Malcolm J. Birch ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Outcome Measures ◽  
Consecutive Series ◽  
Gap Size ◽  
Velopharyngeal Closure ◽  
Submucous Cleft Palate ◽  
A Prospective Study ◽  
Nasal Emission ◽  
Outcome Of Surgery

Objective This study was designed to determine whether velar surgery was worthwhile for submucous cleft palate (SMCP) and evaluate whether results were dependent on the degree of the anatomical abnormality. Design A prospective study of a consecutive series of patients fulfilling the entry criteria, assessed blindly from records arranged randomly. Patients Fifty-eight patients diagnosed with SMCP and operated on by a single surgeon between June 1991 and April 1997 were reviewed. Forty patients fulfilled the entry criteria. Minimum follow-up was 6 years. Interventions Radical reconstruction of the soft palate musculature was performed by one surgeon using the operating microscope. A scoring system was devised for grading the anatomical severity of submucous cleft (SMCP score). Main Outcome Measures Postoperative hypernasality and nasal emission scores and the degrees of improvement were considered the primary outcome measures, and the degree of velopharyngeal closure was also assessed. Results There were highly significant improvements in hypernasality, nasal emission, and velopharyngeal closure. A preoperative gap size of more than 13 mm was associated with less satisfactory outcomes, but gap size was not predictive of improvement. Severity of the SMCP did not correlate with the degree of preoperative speech abnormality but was a significant predictor of outcome of surgery, with the less severe (total SMCP score of 0 to 3) having less satisfactory end results and lesser degrees of improvement. Patients with less abnormal muscle anatomy had lesser degrees of improvement. Conclusion Repair of the muscle abnormality in SMCP is recommended as the first line of treatment in most cases.

scholarly journals Detection and classification of unilateral cleft alveolus with and without cleft palate on panoramic radiographs using a deep learning system

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chiaki Kuwada ◽  
Yoshiko Ariji ◽  
Yoshitaka Kise ◽  
Takuma Funakoshi ◽  
Motoki Fukuda ◽  
...  
Keyword(s):  
Deep Learning ◽  
Cleft Palate ◽  
Panoramic Radiography ◽  
False Positive Rate ◽  
Normal Subjects ◽  
Learning System ◽  
Panoramic Radiographs ◽  
Positive Rate ◽  
Aided Diagnosis

AbstractAlthough panoramic radiography has a role in the examination of patients with cleft alveolus (CA), its appearances is sometimes difficult to interpret. The aims of this study were to develop a computer-aided diagnosis system for diagnosing the CA status on panoramic radiographs using a deep learning object detection technique with and without normal data in the learning process, to verify its performance in comparison to human observers, and to clarify some characteristic appearances probably related to the performance. The panoramic radiographs of 383 CA patients with cleft palate (CA with CP) or without cleft palate (CA only) and 210 patients without CA (normal) were used to create two models on the DetectNet. The models 1 and 2 were developed based on the data without and with normal subjects, respectively, to detect the CAs and classify them into with or without CP. The model 2 reduced the false positive rate (1/30) compared to the model 1 (12/30). The overall accuracy of Model 2 was higher than Model 1 and human observers. The model created in this study appeared to have the potential to detect and classify CAs on panoramic radiographs, and might be useful to assist the human observers.

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