• 제목/요약/키워드: 연인두폐쇄부전

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연인두 폐쇄 부전 환자의 보상조음 특성

  • 이은경;손영익
    • 대한음성언어의학회:학술대회논문집
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    • 대한음성언어의학회 2003년도 제19회 학술대회
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    • pp.146-146
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    • 2003
  • 연인두 폐쇄 부전으로 보상조음이 있을 때, 말 명료도를 저하시킬 뿐 아니라 실제의 연인두 기능이 과소평가 될 수 있으므로 이에 대한 감별 및 언어치료가 필수적이다. 본 연구에서는 연인두 폐쇄 부전 환자들에서 보상조음의 출현율을 알아보고 어떤 음소들이 영향을 받는지 살펴보고자 하였다. 또한 연령과 과비성의 정도에 따른 차이도 살펴보았다. 1998년 3월부터 2003년 6월까지 삼성서울병원에서 연인두 폐쇄 부전으로 진단 받고 언어치료를 받지 않았거나 언어치료 경험은 있지만 일반화되지 않고 중단된 환자 105명의 조음 및 공명 평가 자료를 분석하였다. 연령은 평균 11.3세(2.1세부터 63세)였고 7세 이하의 아동집단이 65명, 성인집단이 40명이었다. 조음은 구강압력자음인 파열음, 마찰음, 파찰음에서의 보상조음의 유무 및 종류를 분석하였다. 과비성의 정도는 경도, 중도, 심도로 평가하였다. (중략)

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정상시와 인위적 연인두 폐쇄 부전시 모음에 따른 비음치 연구 (The Effects of Vowel Type on the Nasalance score in Normal Condition and in Simulated VPI Condition)

  • 최홍식;이성은;황민아;김세헌
    • 대한후두음성언어의학회지
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    • 제13권1호
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    • pp.45-51
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    • 2002
  • The purpose of this study is to examine the effects of vowel type on the nasalance score. Twenty one male adults without VPI produced 5 types of vowels (/a/, /e/, /i/, /o/, /u/) in two conditions-normal and simulated VPI condition. Nasalance scores were measured for each vowel. These data were compared between conditions and among vowel types. The results were as follow : For all vowels, nasalance scores were significantly higher in simulated VPI condition than in normal condition. The two conditions yielded different patterns in terms of the degree of nasalance across the 5 vowels. In normal condition, nasalance scores were higher in front vowels than in medial or back vowels. But in simulated VPI condition, nasalance scores were higher in high vowels than in mid or low vowels.

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점막하구개열 수술 후 지속된 구개인두부전에 대한 수축근 구개인두성형술 증례 (A Case of Sphincter Pharyngoplasty for Persistent Velopharyngeal Insufficiency After Submucosal Cleft Palate Surgery)

  • 이윤형;최연수;김성열;최정석
    • 대한후두음성언어의학회지
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    • 제33권3호
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    • pp.188-192
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    • 2022
  • Velopharyngeal insufficiency (VPI) is a phenomenon that can occur due to anatomical or neurological causes of the soft palate. VPI can make the patient difficult to articulate through hypernasality and nasal emission. There has been needed the customized treatment, as VPI can occur for many causes. We present the case of 21-year-old male who took palate plastic surgery 20 years ago for congenital submucosal cleft palate. As he had poor contraction of both lateral side of velopharynx, he was diagnosed with coronal type VPI. Through sphincter pharyngoplasty, he can obtain improvement of articulation accuracy. We would like to share this challenged case.

연인두 폐쇄부전 아동의 보상조음과 정조음에서의 비음치 비교 (Comparison of Nasalance Score Between Glottal and Oral Articulation in Children with Velopharyngeal Insufficiency)

  • 이은경;손영익
    • 대한후두음성언어의학회지
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    • 제18권2호
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    • pp.129-133
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    • 2007
  • Background and Objectives: Nasometry is an easy, noninvasive method to obtain objective data regarding the function of velopharynx. However, because articulation errors may affect the results of nasometry, the examiner should interpret the nasalance score based on appropriate speech stimuli. The purpose of this study is to examine the difference of nasalance score between glottal and oral articulations in patients with velopharyngeal insufficiency (VPI). Materials and Method: Nineteen children between 3.4 and 12.1 years of age (mean age 5.7 years) with a confirmed VPl showing hypernasality and articulation errors (glottal stops) were included. Nasalance scores were obtained for two speech patterns of glottal and oral stops. In addition, the velopharyngeal functions were analyzed in four subjects using video nasopharyngoscopy. Results: The $mean{\pm}S.D$ nasalance scores of the glottal stops and oral stops were $42.54{\pm}16.26%$ and $25.47{\pm}16.51%$ respectively (p=.000). Six of 19 patients achieved normal nasalance scores when glottal stops changed to oral stops by the trial speech therapy. Video nasopharyngoscope confirmed that large velopharyngeal gaps can be decreased into tiny gaps or complete closure when compensatory articulations were corrected for some cases. Conclusion: Compensatory articulation errors must be corrected for the reliable interpretation of the nasalance scores that are obtained in children with velopharyngeal insufficiency, which would facilitate to make a better decision for further management of these patients.

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과대비성을 동반한 점막하구개열 환자에 대한 Double Opposing Z-plasty를 통한 수술적 치료 결과 (Outcomes for Patients with Submucous Cleft Palate Accompanying Hypernasality Treated with Double Opposing Z-plasty)

  • 김현준;김진영;배정호;김광문;최홍식
    • 대한후두음성언어의학회지
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    • 제11권1호
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    • pp.81-86
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    • 2000
  • Submucous cleft palate is a relatively uncommon congenital anomaly accompanying velopharyngeal incompetence(VPI). Double opposing Z-plasty has many advantages including prolongation of soft palate, normal midfacial growth, midline scar. We analyzed postoperative results comparing with those of preoperative evaluation by several variables(nasometer, endoscopy, satisfactory scale) in 14 patients treated with double opposing Z-plasty due to submcous cleft palate. Nasalance score in Ah sound, Ma phrase, and Pa phrase decreased 20.23%, 3.25%, and 23.26% in the average, respectively. As a result, hypernasality improved significantly. Closure rate in velum evaluated by endoscopy was increased from 0.44 to 0.76. In objective satisfactory scale checked by each patient's guardian at the postoperative period, much improved in 3, improved in 6, minimally improved in 1, and no difference in 1 was reported. (n=11 patients) Double opposing B-plasty is a good surgical modality in patients accompanying VPI with submucous cleft palate or incomplete cleft palate and will be used more usefully and widely.

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구개열로 인한 연인두 폐쇄 부전 환자의 보상조음 (The Compensatory Articulation in the Patients with Cleft Palate having Velopharyngeal Insufficiency)

  • 이은경;박미경;손영익
    • 대한후두음성언어의학회지
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    • 제16권2호
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    • pp.118-122
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    • 2005
  • Background and Objectives The compensatory articulation not only influences general speech intelligibility, but also prevents precise assessment of the velopharyngeal function. This study was performed to investigate frequently affected phonemes, prevalence and the characteristics of compensatory articulation in the patients with cleft palate having velopharyngeal insufficiency. Material and Method An archival review was taken on 103 cleft palate subjects. Their age ranged from 2.6 to 63 years (mean age of 9.8 years). They were grouped into two : preschool group (n=71) and older patient group (n=32). The prevalence and patterns of compensatory articulation were examined on oral high pressure consonants such as plosives, fricatives and affricates. Results : Compensatory errors were observed in $49.5\%$ of the subjects and were mostly glottal stops with the exception of 4cases who had pharyngeal fricatives in addition to glottal stops. The most frequently substituted phonemes were velar plosives and tense sound. There was no significant difference of prevalence in both groups. However, errors for bilabial and alveolar plosives were more frequently observed in preschool group. Conclusion High prevalence of compensatory articulation observed in both preschool and older age group indicates that their articulation errors tend to remain unless appropriate speech therapy is provided. To improve speech intelligibility of the patients with cleft palate having velopharyngeal insufficiency, it is advisable to address and correct the compensatory articulation errors in their earlier ages.

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