Laryngeal Airway Resistance in Children with Cleft Palate and Adequate Velopharyngeal Function

1995 ◽  
Vol 32 (2) ◽  
pp. 138-144 ◽  
Author(s):  
David J. Zajac
Keyword(s):  
Cleft Palate ◽  
Airway Resistance ◽  
Velopharyngeal Function ◽  
Laryngeal Airway

Laryngeal Airway Resistance in Children with Cleft Palate and Adequate Velopharyngeal Function

1995 ◽  
Vol 32 (2) ◽  
pp. 138-144 ◽  
Author(s):  
David J. Zajac
Keyword(s):  
Cleft Palate ◽  
Airway Resistance ◽  
Vowel Production ◽  
Effort Level ◽  
Syllable Repetition ◽  
Velopharyngeal Closure ◽  
Velopharyngeal Function ◽  
Laryngeal Resistance ◽  
Repetition Task ◽  
Laryngeal Airway

Laryngeal airway resistance during vowel production was determined for 10 children without cleft palate and 14 children with cleft palate and adequate velopharyngeal function. The children with cleft palate were further grouped according to either complete or incomplete velopharyngeal closure. All children performed a syllable repetition task with nostrils occluded at self-determined effort and a targeted effort typical of adult speech. Results indicated that all children exhibited significantly greater laryngeal resistance at self-determined effort. No significant differences occurred among the groups of children at either effort level. Some children with incomplete velopharyngeal closure, however, tended to exhibit relatively increased laryngeal resistance at the targeted effort level when their nostrils were unoccluded. Implications for a regulation-control model of speech production and clinical assessment are discussed.

Instrumental Assessment in Cleft Palate Care

2013 ◽  
Vol 23 (2) ◽  
pp. 49-61 ◽  
Author(s):  
Jamie Perry ◽  
Graham Schenck
Keyword(s):  
Cleft Palate ◽  
New Developments ◽  
Perceptual Evaluation ◽  
Advantages And Disadvantages ◽  
Instrumental Assessment ◽  
Speech Language Pathologist ◽  
Hypernasal Speech ◽  
Perceptual Assessment ◽  
Velopharyngeal Function ◽  
And Function

Despite advances in surgical management, it is estimated that 20–30% of children with repaired cleft palate will continue to have hypernasal speech and require a second surgery to create normal velopharyngeal function (Bricknell, McFadden, & Curran, 2002; Härtel, Karsten, & Gundlach, 1994; McWilliams, 1990). A qualitative perceptual assessment by a speech-language pathologist is considered the most important step of the evaluation for children with resonance disorders (Peterson-Falzone, Hardin-Jones, & Karnell, 2010). Direct and indirect instrumental analyses should be used to confirm or validate the perceptual evaluation of an experienced speech-language pathologist (Paal, Reulbach, Strobel-Schwarthoff, Nkenke, & Schuster, 2005). The purpose of this article is to provide an overview of current instrumental assessment methods used in cleft palate care. Both direct and indirect instrumental procedures will be reviewed with descriptions of the advantages and disadvantages of each. Lastly, new developments for evaluating velopharyngeal structures and function will be provided.

Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate

2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
English Speaking ◽  
And Gender ◽  
Early Primary ◽  
Velopharyngeal Function ◽  
Normal Speech

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.

Cleft Palate in Kabuki Syndrome: A Report of Six Cases

2006 ◽  
Vol 43 (6) ◽  
pp. 756-761 ◽  
Author(s):  
Takuya Iida ◽  
Susam Park ◽  
Kogo Kato ◽  
Ichiko Kitano
Keyword(s):  
Cleft Palate ◽  
Clinical Features ◽  
Congenital Anomalies ◽  
Kabuki Syndrome ◽  
Characteristic Appearance ◽  
Submucous Cleft Palate ◽  
Velopharyngeal Function

Kabuki syndrome is a syndrome of rare congenital anomalies that was named after its characteristic appearance, a face resembling that of an actor in a Kabuki play. Although cleft palate is a feature that is sometimes observed in patients with Kabuki syndrome, there are few clinical reports of cleft palate associated with Kabuki syndrome. This report presents six cases of Kabuki syndrome with cleft palate and reviews their clinical features. Our results suggest that (1) patients with cleft palate in Kabuki syndrome tend to fail in acquiring normal velopharyngeal function and (2) submucous cleft palate might be more common in patients with Kabuki syndrome than previously was reported.

Age and Laryngeal Airway Resistance During Vowel Production in Women

1992 ◽  
Vol 35 (2) ◽  
pp. 309-313 ◽  
Author(s):  
Jeannette D. Hoit ◽  
Thomas J. Hixon
Keyword(s):  
Speech Production ◽  
Airway Resistance ◽  
Clinical Implications ◽  
Vowel Production ◽  
Laryngeal Function ◽  
Healthy Women ◽  
Laryngeal Airway

An investigation was conducted to determine if laryngeal valving economy, as reflected in measures of laryngeal airway resistance during vowel production, differs with age in women. Seventy healthy women were studied, 10 each at age 25, 35, 45, 55, 65, 75, and 85 years. Results indicated that laryngeal airway resistance did not differ significantly with age, although it was noted that the 45-year-old women generally had lower laryngeal airway resistance values. This pattern of function differs from that observed in men (Melcon, Hoit, & Hixon, 1989). Discussion of findings includes consideration of factors that might influence laryngeal function during speech production in women. Clinical implications are offered.

scholarly journals A Clinical Method for Estimating Laryngeal Airway Resistance during Vowel Production

1981 ◽  
Vol 46 (2) ◽  
pp. 138-146 ◽  
Author(s):  
Judith R. Smitheran ◽  
Thomas J. Hixon
Keyword(s):  
Airway Resistance ◽  
Great Promise ◽  
Adult Males ◽  
Clinical Tool ◽  
Vowel Production ◽  
Mean Values ◽  
Clinical Method ◽  
Oral Pressure ◽  
Airway Opening ◽  
Laryngeal Airway

A noninvasive clinical method for estimating laryngeal airway resistance during vowel production is described. Resistance is calculated from the ratio of translaryngeal pressure to translaryngeal flow, the first determined from measurement of oral pressure and the second determine from measurement of airway-opening flow made during the production of a specially designed utterance. Application of the method to the study of vowels resulted in a calculated mean laryngeal airway resistance of 35.7 cm H 2 O/LPS for 15 normal adult males. This resistance value is remarkably similar to mean values obtained in previous research using complex invasive experimental methods. Clinical use of the method is illustrated in case studies that highlight both evaluation and management potentials. It is concluded that the method proposed is clinically practical, that the data it provides are both valid and reliable, and that the method shows great promise of becoming a routine clinical tool for estimating laryngeal airway resistance during vowel production.

Perceptual Evaluation of Speech and Velopharyngeal Function in Children with and without Cleft Palate and the Relationship to Nasal Airflow Patterns

2002 ◽  
Vol 39 (4) ◽  
pp. 409-424 ◽  
Author(s):  
Hans Dotevall ◽  
Anette Lohmander-Agerskov ◽  
Hasse Ejnell ◽  
Björn Bake
Keyword(s):  
Cleft Palate ◽  
Sensitivity And Specificity ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Strong Association ◽  
Airflow Rate ◽  
Nasal Airflow ◽  
Perceptual Evaluation ◽  
Velopharyngeal Function ◽  
The Relationship

Objectives The aim was to study the relationship between perceptual evaluation of speech variables related to velopharyngeal function and the pattern of nasal airflow during the velopharyngeal closing phase in speech in children with and without cleft palate. Participants Fourteen children with cleft lip and palate or cleft palate only and 15 controls aged 7 and 10 years. All were native Swedish speakers. Method Three experienced listeners performed a blinded perceptual speech evaluation. Nasal airflow was transduced with a pneumotachograph attached to a nasal mask. The duration from peak to 5% nasal airflow, maximum flow declination rate, and nasal airflow at selected points in time during the transition from nasal to stop consonants in bilabial and velar articulatory positions in sentences were estimated. The analysis was focused on the perceptual ratings of “velopharyngeal function” and “hypernasality.” Results A strong association was found between ratings of “velopharyngeal function” and “hypernasality” and the pattern of nasal airflow during the bilabial nasal-to-stop combination /mp/. Both the sensitivity and specificity were 1.00 for the bilabial temporal airflow measure in relation to ratings of “velopharyngeal function.” The nasal airflow rate during /p/ in /mp/ had a sensitivity of 1.00 and specificity of 0.92 to 0.96 in relation to ratings of “hypernasality.” Conclusion Assessment of the nasal airflow dynamics during the velopharyngeal closing phase in speech presents quantitative, objective data that appear to distinguish between perceptually normal and deviant velopharyngeal function with high sensitivity and specificity.

Sign in / Sign up

Export Citation Format

Share Document