Maxillofacial Plastic and Reconstructive Surgery

  • 제41권
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  • Pages.19.1-19.6
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  • 2019
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  • 2288-8101(pISSN)
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  • 2288-8586(eISSN)
대한악안면성형재건외과학회 (Korean Association of Maxillofacial Plastic and Reconstructive Surgeons)
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Treatment of velopharyngeal insufficiency in a patient with a submucous cleft palate using a speech aid: the more treatment options, the better the treatment results

  • Park, Yun-Ha (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University Dental Hospital) ;
  • Jo, Hyun-Jun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University Dental Hospital) ;
  • Hong, In-Seok (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University Dental Hospital) ;
  • Leem, Dae-Ho (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University Dental Hospital) ;
  • Baek, Jin-A (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University Dental Hospital) ;
  • Ko, Seung-O (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University Dental Hospital)
  • 투고 : 2018.12.03
  • 심사 : 2019.03.28
  • 발행 : 2019.12.31
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초록

Background: The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy. Case presentation: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal. Conclusions: Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.

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참고문헌

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피인용 문헌

  1. An Observational Study to Evaluate Association Between Velopharyngeal Anatomy and Speech Outcomes in Adult Patients With Severe Velopharyngeal Insufficiency vol.32, pp.8, 2019, https://doi.org/10.1097/scs.0000000000007853
  2. Automatic detection of pharyngeal fricatives in cleft palate speech using acoustic features based on the vocal tract area spectrum vol.68, 2019, https://doi.org/10.1016/j.csl.2021.101203
  3. Speech-aid prosthesis in velopharyngeal incompetency patient with cleft palate: can speech aids be applicable for adult patient? vol.43, pp.1, 2019, https://doi.org/10.1186/s40902-021-00315-5