• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.1
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• pp.34-38
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• 2001

Background and Objectives : With the development of computerized systems, an objective evaluation methods of nasal speech and nasal geometry have become readily available by means of a simple, noninvasive technique. In this study, we assessed the nasality, nasal formant, nasal volume and nasal area in patients with hypertrophic rhinitis before and after turbinate surgery. Material and Method : With the nasometer, we measured nasalance, which reflects the ratio of acoustic energy output of nasal sounds from the nasal and oral cavities. With CSL 4300B, we measured nasal formants. We used acoustic rhinometer to measure nasal area and nasal volume. Postoperative changes of above factors were compared with preoperative values. Paired t-test and Pearson's correlation were used for statistical analysis. Results : The first nasal formant frequency, nasalance scores of three passages(baby, mamma and rabbit passages), minimal cross sectional area(MCA) of narrow side, nasal volume of narrow side and nasal volume of wide side had increased significantly after turbinate surgery (p <0.05). The MCA and nasal volume of narrow side and MCA of wide side showed significant correlation with nasalance score of rabbit passage and baby passage showed significant correlation with nasal volume of narrow side(p<0.05). Conclusion : There were significant increases in nasalance scores, first nasal formant frequency, MCA and nasal volume after turbinate surgery. Thus, we must consider the possibility of voice changes postoperatively in professional voice users.

• Korean Journal of Cleft Lip And Palate
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• v.7 no.2
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• pp.123-132
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• 2004

The purpose of this study was to obtain normative nasalance scores for adult subjects speaking the Korean language. Additional objectives of the study were to determine if speaker sex played a role in differences in nasalance score and there was significantly correlation of nasalance score with nasalance slope score. The subjects include 75 healthy young Korean adults with normal oral and velopharyngeal resource and function. They had no history of speech problem, were judged as having normal speech and resonance at the time of testing, and had no upper respiratory tract infections or allergies at the time of testing. The Nasometer II 6400 was used to obtain nasalance scores and nasalance slope scores for /a/, /i/, /e/, /o/, /u/, /ja/, /je/, /wi/, /p'ap'i/ and /sasi/. The data of nasalance and nasalance slope were analyzed statistically. The mean nasalance score of the female was significantly higher than that of male at /a/, /i/, /wi/, /p'ap'i/ and /sasi/(p <0.10). The mean nasalance score of /i/ was highest and that of /o/ was the lowest. In this study, we could not and the relationship of the nasalance score and the closing slope score. However, there was negative correlation between the mean nasalance score and the opening slope score at ie/ and /;ai, positive to /sasi/. These normative nasalance scores for normal young adults speaking the Korean language provide important reference information for Korean cleft palate teams. In the future study of velopharygneal activity with the Nasometer, the opening slope score will be able to be the important parameter.

• Proceedings of the KSPS conference
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• 1996.02a
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• pp.23-40
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• 1996

The communicative disorders in cleft palate patients have relationship with the acoustic and He physiological phenomena. Particularily hypernasality is a parameter of cleft palate speech that has been studied by many clinicians and speech pathologists. The degree of hypernasality has been assessed by the listener,s judgement, but perceptual assessements have poor scientific reliability, so objective instruments have been needed to test hypernasality with diagnostics accuracy. This study was analyzed the nasalance score using a Nasometer for cleft palate patients. The simple vowels /a/, /i/, /e/ and the approximants /j/, /w/ were tested for the degree of hypernasality after operation. The phrases containing long and short duration times were used in this study to asses hypeernasality. Fiberopic views shows the open velopharyngeal port that resulted in hypernasality of cleft palate patients. The authors assert the important of the management of cleft palate patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.13-20
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• 2006

The articulation disorders associated with velopharyngeal insufficiency (VPI) in cleft palate patients are interested to clinicians particularly. The purpose of this study was to investigate mainly the oropharyngeal air pressure and overall air flow in cleft palate patients. The pressure-measuring catheter was positioned at the midportion of the oropharyngeal cavity with a facial mask. Test words were composed of 9 meaningless polysyllabic words and 17 meaningful words. Aerophone II and Nasometer II were used to measure peak air pressure, mean air pressure, maximum flow rate, volume, phonatory flow rate, nasalance. The data shows that airflow of the cleft palate patient group were higher than those of the control group. Intraoral air pressure of the cleft palate patient group was lower than those of the control group. The first vowel formant and first Bandwidths of the cleft palate patient group were higher than those of the control group.

• Speech Sciences
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• v.3
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• pp.18-25
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• 1998

Background: The results of treatment in functional velopharyngeal insufficiency (VPI) was not good compared to physician's common practice. Objectives: Authors conducted this study to evaluate the efficacy of fat injection on posterior pharyngeal wall in the functional velopharyngeal insufficiency as the supportive treatment. Materials and Methods: The preoperative assessment includes history of patients, the perceptual analysis of patient's voice, nasopharyngoscopic finding of velopharyngeal movements, nasometer, movement findings of soft palate during phonation and swalling. Fat which was taken from umbilical area was injected in 5 patients with conducted functional velopharyngeal insufficiency. Results: All 5 patients had good results in voice quality after fat injection. Conclusions: Fat injection is a good treatment method in functional velopharyngeal insufficiency as a supportive method.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.19.1-19.6
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• 2019

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.

• Korean Journal of Cleft Lip And Palate
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• v.12 no.1
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• pp.1-6
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• 2009

Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter, had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in $mm^2$. Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.2
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• pp.128-132
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• 2010

Background and Objectives : This study was designed to examine the effect of nasal cavity surgery on voice in terms of nasalance by using subjective test, Visual analogue scale (VAS) and Nasometer and compare the pre op and post op results among patiets with nasal cavity disease. Materials and Method : From April 2009 to November 2009, data of thirty one patients who underwent nasal cavity surgery were prospectively evaluated. 24 males and 7 females with age range between 12 years to 80 years old (average 34 years old) were chosen. VAS was questioned to patients group before, after 1 week, after 1 month, and after 3 months from the surgery. Nasometer, was also conducted. Results: After the surgery symptoms like nasal obstruction, mouth breath, snoring, and sleep apnea were all improved. Improvements for nasal obstruction and mouth breath were observed statistically in post operative day (POD) 1 month and POD 3 months. Also snoring was improved statistically in POD 1 month. Objective nasalance test showed increases in a single and double vowel for POD 3 months. Only /je/ sound statistically-significant increased in all post operative periods. Nasalance increase were observed in other test results. Conclusion : All the symptoms are improved after nasal cavity surgery. Also there are some nasalance changes during whole period of study and return to the pre operative state in POD 3 months. Therefore, patients must be warned and understood about nasalance changes, and surgeons need to aware of various facts, which can affect voice changes before the surgery.

• Speech Sciences
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• v.9 no.3
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• pp.133-140
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• 2002

The purpose of this study was to investigate any changes in acoustic qualities of voice as ,a function of nasalance, in order to determine the relationship between vocal quality and nasalance. Twenty normal subjects (10 males and 10 females) vocalized /a/, /$\tilde{a}$/, and /a $\eta$/. The changes in nasalance and acoustic characteristics of the voice were analyzed by Nasometer (Model 6200-3, Kay Elemetrics, co) and Dr, Speech 4.0 (Tiger Electronics, Co), respectively. One-way ANOVA was used to examine any changes in jitter, shimmer, harmonics-to-noise ratio, and normalized noise energy relative to the nasalance in 3 types of vocalization. The Person r correlation coefficient was used to identify the relationship between the nasalance and the vocal quality. There was no statistically significant changes in jitter, shimmer, HNR and NNE. The jitter, however, tended to increase as the nasalance socre increased, compared to the other vocal parameters. In addition, the NNE showed an increase on / $\tilde{a}$/, and /a $\eta$/, more on the /a $\eta$/. Thus, it was speculated that NNE could be used to identify or screen resonant disorders with hypernasality

• Speech Sciences
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• v.10 no.2
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• pp.191-203
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• 2003

This study examined the effect of vocal loudness on nasalance measures, under the conditions of three sentence patterns (i.e., Oral sentences, Mixed sentences, Nasal sentences). The vocal loudness level was classified into soft voice (55 dB), medium voice (65 dB) and loud voice (75 dB). The participants in the present study were 30 normal adults (male: female =1:1). Kay's Nasometer 6200 was used to measure nasalance and Sound level meter was used to adjust the loudness level. The results of the present study are as follows. Firstly, the change in vocal loudness is in the following. In the Oral sentence stimuli, the loud voice for both male and female showed the highest nasalance degree, and the medium voice the lowest level. In the Mixed and Nasal sentence stimuli, however, male participants showed the highest degree of nasalance in the soft voice, and the lowest degree in the loud voice, and female showed the highest degree of nasalance in the soft voice and the lowest in the medium voice. Secondly, when each subject's nasalance scores were ranked in a ordered manner, noticeable tendency. Lowest nasalance score occurred in the loud voice and the highest nasalance score was recorded in the soft voice during participants' reading of the Nasal sentences. However, it was hard to find such pattern in the Oral sentences. It is assumed that velopharyngeal function could be related to these findings. Furthermore, the findings associated with vocal loudness may have diagnostic as well as clinical implications.