• 음성과학
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• 제12권1호
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• pp.27-35
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• 2005

Differential instrumentation for the diagnoses of individuals with Cleft palate has been used to objectively measure speech problems. The Cepstrum Method was used to study the vocal tract transfer function. The vocal tract transfer function and the source spectrum should be considered in the evaluation of nasal resonance. The aim of this study was to collect quantitative data on the acoustic Instrumentation used for evaluating hypernasality. Normal subjects (9 male, 21 female; 37 male children, 20 female children) and individuals with VPI (13 male, 8 female; 16 male children, 9 female) participated in this study. The vowel /i/ was selected to gauge the severances of hypernasality Spectral and Cepstral studies using CSL was used to identify the acoustic characteristics. Cepstrum analysis shows significant differences in quefrency and amplitude. The quefrency of normal groups was shorter than that of the VPI groups, while the amplitude of normal groups was lower than that of the VPI groups. This may have significance in the evaluation 'of nasal resonance.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.23.1-23.6
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• 2018

Background: Velopharyngeal insufficiency that accompanies speech resonance and articulation disorders can be managed through several intervention methods such as speech-language therapy, prosthetic aids, and surgery. However, for patients with severe hypernasality, surgical interventions are highly recommended. Among available surgical techniques, the posterior pharyngeal flap is most common. Case presentation: Two adult males with high nasalance scores underwent superiorly based posterior pharyngeal flap surgery, followed by speech testing by an expert speech-language therapist. Nasalance scores and articulation accuracy were assessed up until 1 year after the surgery. Nasalance scores were measured five times using a nasometer, after which the average value was calculated. Conclusions: Consistent declines in hypernasality over time are not easy to explain since the pedicled pharyngeal flap narrowed over time, secondary to cicatrization. However, scar tethering of the soft palate in a posterior direction could reduce the velopharyngeal port size over time. Therefore, long-term follow-up with intensive speech therapy is suggested for patients with severe hypernasality.

• Archives of Plastic Surgery
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• 제32권5호
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• pp.660-662
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• 2005

It is well documented that adenoidectomy is attributed to hypernasality in certain cases, but not clear that the enlarged tonsils affect the quality of speech. Hypertrophied tonsils may cause and complicate the problem of velopharyngeal incompetency. The huge tonsils prevent lateral pharyngeal walls from a medial movement and interfere velar elevation, being hypernasality. Hyponasality developes as the tonsils encroach in nasopharyngeal space. Voluminous tonsils also interfere airflow in the oropharyneal passage and produce the phenomenon of cul-de-sac resonance or muffled sound. The authors and et al. present a case of velopharyngeal insufficiency accompanied with hypertrophic tonsils. Improving the lateral constricting pharyngeal wall and velar elevation after tonsillectomy minimized the velopharyngeal gap. Accordingly, the procedures of sphincter pharyngoplasty and palatal lengthening resolved the problem of hypernasality instead of pharyngeal flap. Tonsillectomy prior to pharyngeal flap surgery tends to reduce the postoperative airway problems. Sometimes, however, only tonsillectomy does without pharyngeal flap. Surgical approach by stages and intermittent evaluation are recommended at intervals of at least six weeks.

• 대한후두음성언어의학회지
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• 제6권1호
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• pp.46-55
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• 1995

Authors devised an objective test for nasal resonatory disorders using a vibratory sensor(Piezoelectric receiver) which is relatively cheap. The vibratory sensor was covered with duralumin to eliminate contamination of acoustic sound except a small hole which is attached on ala nasi during the test. Electrical signals front the vibratory sensor and the microphone while the subject is phonating vowel/a/ and nasal consonant /ng/ and phonating 8 syllable sentence /papa/ passage and /mama/ passage were digitized with n 12 bit A/D converter. For the evaluation of the hypernasality, the ratio of /ng/ to /a/ and /mama/ passage to /papa/ passage were used instead of individual values to reduce the observational error. For the evaluation of the hyponasality, the cul-de-sac resonation was induced by obstructing the nasal aperture of the ipsilateral side with the finger. In the normal control group, the ratio of /ng/ to /a/ and /mama/ passage to /papa/ passage was larger than 8. In the hypernasality with nasal emission group. the ratio was decreased markedly(p＜0.01). When the nasal aperture was obstructed with the finger, the vibratory signals of /a/ and /ng/ were increased markedly in the control group and hypernasality group(p＜0.01). However, in the hyponasality group(severe), the increment was minimal. So this system can be used to detect the nasal resonatory disorders objectively and differentiate the hypernasality front hyponasality easily.

• 대한후두음성언어의학회지
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• 제9권2호
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• pp.164-167
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• 1998

Myasthenia gravis is a neuromuscular disorder that affects striated muscles especially those innervated by the cranial nerves. Most patients present with symptoms relating to the head and neck and thus may be seen first by the otolaryngologist. Recently we had experienced a case of myasthenia gravis with the complaints of hypernasality and voice fatigue in a 49 year old male. In this case, all symptoms were improved markedly with administration of anticholinesterase.

• 대한치과의사협회지
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• 제13권7호
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• pp.633-636
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• 1975

The pt, a 16 years old Korean female, had been afflicted with hypernasality, which had been the cause of reticency and unsociable attitude. She was corrected by superiorly based flap operation.

• 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.

• 대한후두음성언어의학회지
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• 제13권2호
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• pp.180-187
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• 2002

Background and Objectives : The operation Double Opposing Z-Plasty, has been used for improving VPI function in the submucous cleft palate. However, few reports on the effects of the speech change were presented. The purpose of this study is to compare the difference of nasality and nasalance, parents satisfaction between before and after this operation and to consider how much improvement in speech. Materials and Methods : Ten submucous cleft palate children who underwent double opposing Z-plasty were analyzed. We retrospectively studied nasalance, auditory perception (nasality) with hypernasality, patients satisfaction, speech evaluation by using charts review, video tape, telephone interview. Results : In 8 patients of 10 submucous cleft palate, hypernasality reduced and speech intelligibility was higher and mean 0.35 point was increased in the velum length after operation. After operation, nasality was improved (2.0 point) and level of nasal emission decreased. Regarding satisfaction of this operation, scale was mean 2.8 (5 point-scale) : 8 parents were satisfied in the resonance, 3 parents were satisfied articulation. The reason of dissatisfaction was mostly compensatory articulation. Conclusion : To improve of speech in the submucous cleft palate, speech therapy afterthis operation as well as successful surgery should be considered.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권5호
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• pp.483-488
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• 2006

Velopharyngeal function refers to the combined activity of the soft palate and pharynx in closing and opening the velopharyngeal port to the required degree. In normal speech, various muscles of palate & pharynx function as sphincter and occlude the oropharynx from the nasopharynx during the production of oral consonant sounds. Inadequate velopharyngeal function caused by neurologic disorder - cerebral apoplexy, regressive diseases - disseminated sclerosis, Parkinson's disease, congenital deformity - cleft palate, cerebral palsy and etc. may result in abnormal speech characterized by hypernasality, nasal emission and decreased intelligibility of speech due to weak consonant production. In our study, we constructed speech aids prosthesis - Speech bulb in the incomplete cleft palate VPI patient with hypernasality and assessed velopharyngeal function with nasometer which can evaluate the speech characteristics objectively.

• 대한소아치과학회지
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• 제27권4호
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• pp.517-523
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• 2000

비인강폐쇄는 연구개, 인두측벽 그리고 인두후벽간의 움직임이 서로 조화되어 구강과 비강을 나누어주는 괄약근 기전으로서 연하, 호흡 및 발음 등의 생리적 기능에 중요한 역할을 한다. 이 기능에 문제가 생긴 경우를 비인강폐쇄부전이라하며 그 원인으로는 (1) 연구개의 길이 및 움직임이상, (2) 비인두강의 해부학적 공간문제, (3) 인두후벽과 측벽의 기능이상 등이 있다. 본 연구는 구개열 환자의 측면두부방사선 사진을 통해 비인두강을 해부학적으로 분석하고 동시에 산출된 각 모음의 과비음 정도를 평가하여 비인강폐쇄부전과의 연관성을 비교해 본 것이며, 얻어진 결과는 다음과 같다. 1. 연구개 길이는 정상인에 비해 현저히 짧았다. 2. adequate ratio는 정상인에 비해 작게 나타났다. 3. adequate ratio가 감소함에 따라 모음 조음시 anatomic mVPI가 점차 증가하였다. 4. 각 모음 조음시 anatomic VPI는 과비음정도와 비례관계를 보였다. 5. 고모음(/u/, /i/)의 과비음정도가 저모음(/a/)에 비하여 크게 나타났다. 결론적으로, 구개열환자에서 측면두부방사선 사진은 비인강폐쇄부전의 진단 및 평가에 유용하게 사용될 수 있으며, 비인두강의 해부학적 구조는 산출되는 과비음정도와 밀접한 연관성이 있었다.