• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권5호
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• pp.447-456
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• 2008

There is close relationship between intraoral structural anomaly and speech- functional problem. Patient with cleft palate patients & ankyloglossia is a typical example, patients with structural anomaly is repaired toward normal structure by operation. Ankyloglossia may cause functional limitation even after adequate surgical treatment speech disorders being one of them. Interindividually, they vary a lot, showing typical articulation specifics. The objective of this study was to evaluate and compare speech for children with ankyloglossia and general public, to determine whether ankyloglossia is associated with articulation problem. We wanted to present criteria for indication of frenectomy. The group of subject is composed of 10 childrens with ankyloglossia and articulation problem, visited the Oral and Maxillofacial surgical unit, dental hospital, Chonbuk university. The average age is 5 Y 7M, M : F ratio is 8 : 2 at the time of speech test. Control group is composed of 10 members without oral structural anomaly. The average age is 5 Y 10M, M : F ratio is 3 : 7 at the time of speech test. Outcomes were measured the PPVT(Peabody Picture Vocabulary Test), PCAT(Picture Consonant Articulation Test), Nasometer II test result obtained each group, statistically measured by Mann-whitney's U Test. There was no difference for 'chronological age-age equivalent' between two group. There was significant difference for 'consonant accuracy' between two group, showed more lower scores in subject group. There was more 'consonant error' in subject group, mostly showed/1/,/s/. A major modality of 'consonant error' was mostly distortion and replacement. There was no significant difference between two group for nasality.

• 음성과학
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• 제7권3호
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• pp.229-247
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• 2000

The purpose of this study is to examine the improvement effect of articulation of the fricative consonant /s/(ㅅ), when applying the Articulation Modification Program (AMP) to hearing disordered students. Three hearing disordered students were selected for this study by the consonant picture and Korean Articulation Sentence tests. They have no defect in their emotion, behavior and sight. This program applied the multiple baseline design across subjects to examine the improvement effect of articulation of fricative consonant /s/(ㅅ). Also I designed th$\sim$s program with an advanced pre-test and post-test in order to research the improvement difference of articulation by articulation position and language unit. It was executed 32 sessions over three months, four sessions a week, one session taking forty minutes. The results according to the study subject are as follow; First, as result of AMP, articulation of all students was developed after applying this program. Second, as result of AMP, articulation in fore-word was one-hundred percent efficiency and articulation in middle-word was 97.7% efficiency by position. Third, as result of AMP, articulation in the word reached 98.7% efficiency, in phrase 97.7% efficiency, in the sentence 97.7% efficiency and in the story was 98.3% efficiency by language unit.

• 대한통합의학회지
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• 제8권4호
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• pp.291-305
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• 2020

Purpose : The duration of speech segments reflects children's speech motor development. The purpose of this study was to determine whether segmental sound and word duration varies by age among preschool children. Methods : A total of 60 children aged 4~5 years participated in this study. Participants took the picture-naming test to produce single-word speech data. The duration of the consonant at the initial position of the word and the final position of the word, the voice onset time of plosive, the duration of the vowel following the initial consonant, and the duration of the word were measured. Results : As age increased, the duration of the initial consonant, the duration of the word, and the voice onset time decreased significantly. The main effects of age, manner of articulation, and place of articulation on the duration of the initial consonant were significant. The duration of consonants in the nasal sound and plosives and the duration of bilabial and alveolar sound differed significantly between groups. The main effects of age and vocal type on voice onset time were significant. The main effect of age on the duration of the consonant in the final position of word and on the duration of the vowel were not statistically significant. Conclusion : The results of this study showed that the duration of segmental sound and the word were associated with speech development between 4 and 5 years old. Accordingly, duration of the segmental sound and the word may serve as an acoustic cue as they reflect speech development and speech motor control maturity.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.25-30
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• 2012

Background : The soft palate functions as a valve and helps generate the oral pressure required for normal speech resonance. Speech problems and nasal regurgitation can result from a soft palatal defect. Reduction of the size of the velopharyngeal orifice is required to compensate for the lack of mobility in a reconstructed soft palate. We suggest a large volume folded free flap for reduction of the caliber and a palmaris longus tendon sling for suspension of the reconstructed palate. Methods : Six patients had total soft palate resection for tonsillar cancer and reconstruction with a large volume folded radial forearm free flap combined with a palmaris longus sling. A single surgeon and speech therapist examined the patients with three standardized speech assessment tools: nasometer test, consonant articulation test, and speech acuity test performed for speech evaluation. Results : Mean nasalance score was 76.20% for sentences with nasal sounds and 43.60% for sentences with oral sounds. Hypernasality was seen for oral sound sentences. The mean score of the picture consonant articulation test was 84% (range, 63% to 100%). The mean score of the speech acuity test was 5.84 (range, 5 to 6). These mean ratings represent a satisfactory level of speech function. Conclusions : The large volume folded free flap with a palmaris longus tendon sling for total soft palate reconstruction resulted in satisfactory prognosis for speech despite moderate hypernasality.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.607-612
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• 2010

Purpose: Maxillectomy for malignant tumor resection often leads to functional and aesthetic sequalae. Reconstruction following maxillectomy has been a challenging problem in the field of head and neck cancer surgery. In this article, we described three dimensional midface reconstructions using free flaps and their functional and aesthetic outcomes. Methods: We reconstructed 35 cases of maxillectomy defects using 9 radial forearm free flaps, 7 lattisimus dorsi musculocutaneous free flaps, 6 rectus abdominis musculocutaneous free flaps, 4 fibular osteocutaneous free flaps, and 9 anterolateral thigh free flaps, respectively. We classified post-maxillectomy defects by Brown's classification. 1 Articulation clarity was measured with picture consonant articulation test. Swallowing function was evaluated with the University of Washington quality-of-life Head and Neck questionnaire by 4 steps.2 Aesthetic outcomes were checked to compare preoperative with postoperative full face photographs by 5 medical doctors who did not involve in our operation. Results: The average articulation clarity was 92.4% (100-41.9%). 27 (81.9%) patients were able to eat an unrestricted diet. Aesthetic results were considered excellent in 18 patients (51.4%). Functional results were best in the group reconstructed with fibular osteocutaneous free flap. Considering the range of wide excision, aesthetic results is best in the group reconstructed with anterolateral thigh free flap. Conclusion: The free flap is a useful technique for the reconstruction of the midface leading to good results, both functionally and aesthetically. Especially, because osteocutaneous flap such as fibular osteocutaneous free flap offered bone source for osteointegrated implant, It produces the best functional results. And perforator flap like as anterolateral thigh free flap reliably provides the best aesthetic results, because it provides sufficient volume and has no postoperative volume diminution.

• 말소리와 음성과학
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• 제9권2호
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• pp.125-135
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• 2017

The current study examines PCC (percentage of correct consonant), speech intelligibility, and oral motor function between the group of typically developing children and the group of children with Down's syndrome. To 15 children with Down's syndrome (mean CA: 9;7) and 15 typically developing children on receptive language age, the following tests were administered: K-WPPSI (2001), Picture Vocabulary Test (Kim et al., 1995), Oral and Speech Motor Control Protocol for total oral functional score (Robbins et al., 1987), DDK and Assessment of Phonology and Articulation for Children (APAC, Kim et al., 2007) for PCC and speech intelligibility. Pearson correlation coefficients were computed for the total oral functional score, PCC and DDK of each group. The statistical analysis showed that there is no significant difference in total functional score and DDK when IQ was controlled. There was a significant correlation between total oral functional score and PCC in the Down's syndrome group and a significant correlation between total oral functional score and intelligibility in the Down's syndrome group whether IQ was controlled or not. The findings suggest that both cognitive ability and overall oral motor function need to be considered for the intervention to enhance PCC or speech intelligibility of children with Down's syndrome.

• 대한두경부종양학회지
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• 제25권2호
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• pp.119-122
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• 2009

Objectives : Ablation of carcinoma of the tongue leads to deficits in speech and swallowing, but none to date has provided all of the qualities of mobility and sensation to simulate the complex function of the tongue. The authors evaluated postoperative swallowing and pronouncing function in patients who underwent tongue reconstruction using free flap. Material and Methods : This is a retrospective review documenting the outcome of 42 patients between January of 1991 and August of 2008. We classified patients according to the size of resection of the tongue like as 7 partial glossectomy, 25 hemiglossectomy, 2 subtotal glossectomy, and 8 total glossectomy. Swallowing function was graded into 4 point scale and pronouncing function was analyzed using picture consonant articulation test. Aspiration was evaluated with videofluoroscopic swallowing study. Results : The average points for swallowing function were 3.43 in partial glossectomy, 3.52 in hemiglossectomy, 3 in subtotal glossectomy, and 2.63 in total glossectomy. The percentage of consonants correct showed 76.5% in partial glossectomy, 72.29% in hemiglossectomy, 47.69% in subtotal glossectomy, and 29.94% in total glossectomy. Aspiration was noted in 3 patients(1 hemiglossectomy and 2 total glossectomy) and 2 total glossectomy patients were taken permanent feeding gastrostomy. Conclusion : Free flap gave us proper volume in tongue reconstruction and showed good result in preserving swallowing function. Swallowing function difference according to the size of defect showed no statistical significance, whereas articulation function was shown to decrease in accuracy as the size of defect was larger.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권4호
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• pp.310-317
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• 2002

We have examined 20 tongue-tie patients who had been operated the lingual frenectomy in Dept. of Oral & Maxillofacial surgery, Pusan National University for the effect of the lingual frenectomy on the tongue motion and speech, and divided patients into groups by age. Each group was separated as follows ; the age of 5-6, 7-9, 10-12, 13-15, and 16-18. We measured the frenal lengh, the range of tongue motion and evaluated the speech pre- and postoperatively. The preoperative patient groups have larger tongue tips and smaller lingual frenums than normal ones. In the preoperative patient group, there was significant obstacle of the protrusive and superior movement of the tongue. The exception was the laterotrusive movement on both sides. There was the lower value of the Picture Consonant Articulation Test(PCAT) in the preoperative 5 to 6 year-old group compared with normal group. In other age groups, there was no significant difference. The range of postoperative PCAT in all age groups has become as similiar as that of normal group. The 5 to 6 year-old group which had significant difference in PCAT was improved in PCAT. In conclusion, we propose that the PCAT as well as anatomical tongue size and functional tongue movement is the basis of the indication of lingual frenectomy and the 5-6 year-old is the optimal time of the lingual frenectomy for improvement of the tongue movement and the speech.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권6호
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• pp.526-534
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• 2001

Purpose : The objective of this study is to ascertain whether the positive exists among the frenum length, the tongue movement and the speech and to present the normal range of tongue movement and guidelines for the choice of surgery, observation if necessary. Materials and Methods : 180 patients were evaluated. We divided 180 patients into 6 group by age. Each group was separated as follows; the age of 2.5-4, 5-6, 7-9, 10-12, 16-18. We measured the frenal length, the range of tongue motion and evaluated the speech so that we really questioned about the positive relationship between the tongue-tie and speech. We let the patient exercise the protrusive both(right, left) laterotrusive superior movement of the tongue. During these movements, we measured the distance between the vermilion border and the tongue tip. We also measured the distance from the tongue tip to the point contacting the upper lip with dorsum of the tongue during the maximal protrusive movement of the tongue. Three linear measurement of the anterior, inferior segment of the tongue including the lingual frenum, are made. These measurements are as follows: 1. Distance A. Free anterior portion of the tongue from the point of frenular insertion to the tongue tip. 2. Distance B. The distance from the initiating point of the lingual frenum to the point connecting the two sublingual carundcles to the lingual frenum perpendicularly. 3. Distance C. The distance from the point contacting the line crossing the sublingual caruncles with the lingual frenum to the terminating point of the lingual frenum. We transform three linear measures into a statistical ratio, A/(A-B+C), representing the length of the free portion of the tongue compared with the total sublingual dimensions. In addition, we assessed the speech through Picture Consonant Articulation Test(PCAT) and tried to find out the relationship between the length of the lingual frenum and speech. Conclusion : As people are born, they have small and restricted tongue. As people grow old, tongue motions are more liberate, and unrestricted and they can speak so freely. Therefore we suggest that until age 5, oral and maxillofacial surgeons postpone the surgery if not urgent, evaluate the maximal lingual motions and PCAT according to this article and observe their changes.