• Speech Sciences
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• v.7 no.1
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• pp.39-52
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• 2000

The present study investigates the clinical applicability of a new device which objectively measures nasal resonating vibration via piezoelectric vibratory sensor from 10 normal volunteers, 10 patients with definite hypernasality and 10 nasal polyposis patients. For the assessment of the hypernasality, the ratio of 'ng' to 'a' as well as that of 'mama' to 'papa' passages were used. For the evaluation of hyponasality, the ratio of nasal vibration post- to pre-induced cul-de-sac resonation was calculated. In the control group, the ratio of ng/a and mama/papa passages was larger than 8, while in the hypernasality group, the ratio was markedly lower. The vibratory signals of 'a' and 'ng' increased markedly in the control group and the hypernasality group after inducing cul-de-sac resonation, while in the hyponasality group, the change was minimal.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.6 no.1
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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.

• Korean Journal of Cleft Lip And Palate
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• v.10 no.1
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• pp.33-38
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• 2007

Team approach for the management of cleft lip & palate patients is very important. Plastic surgeon, oral-maxillofacial surgeon, orthodontist, otolaryngologist, and speech therapist should be included in the team. Main role of the ENT surgeon may be variable and is up to the team characteristics. Main topics of ENT surgeons' interesting fields are evaluation and management of hearing impairment due to SOM, voice disorder, and velopharyngeal incompetency due to submucous cleft palate & still remained VPI after curative palatoplasty. Basic review of anatomy & physiology related with otolaryngologic aspect of velopharyngeal system was done. Diseases related with hyponasality as well as hypernasality were discussed. Diagnostic and therapeutic methods were discussed. Proper management of hearing impairment and speech disorders are important.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.2
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• pp.167-171
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• 2000

Nasal obstruction due to nasal deformities, rhinitis, sinusitis, or nasal polyps etc. induces hyponasality, which can influence the articulation and/or phonation of patients. However few studies were done on the subjects. Therefore, this study was performed to establish the guideline that can be used in diagnosing the hyponasality. We analyzed the nasalance scores of 6 different sentences for 26 normal adults. We measured the nasalance scores before simulated nasal obstruction, after one nostril obstruction, and after both nostrils obstruction, while the subjects are reading roe nasal sentences(so-called, 'Mama' sentence, 'Mimi' sentence, and 'Nana' sentence) and three non-nasal sentences('Papa' sentence, 'Bibi' sentence, and 'Tatda' sentence). The change of nasalance score of six sentences were compared in three conditions, that is, without obstruction, with one nostril obstruction, and with both nostrils obstruction. The nasalance scores of one nostril obstruction and both nostrils obstruction were significantly lower than those of no obstruction. The mean nasalance scores of one nostril obstruction and both nostrils obstruction were lower than those of no obstruction by 10.93% and 48.88% in 'Mama' sentence, 3.72% and 5.76% in 'Papa' sentence, 12.28% nd 38.12% in 'Mimi' sentence, 7.28% and 12.96% in 'Bibi' sentence, 13.32% and 34.62% in 'Nana' sentence, 4.27% and 717% in 'Tatda' sentence, respectively. In both nostrils obstruction, the nasalance score of nasal sentences were decreased more than those of non-nasal sentences significantly. The result suggests that nasal sentences can be used as efficient stimuli in assessing the patients suspected of hyponasality. Eventhough non-nasal sentences also induced significant discrimination, the dynamic range was too small.

• Proceedings of the KSLP Conference
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• 2003.11a
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• pp.147-147
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• 2003

Recent aerodynamic and acoustic studies of VPI(velopharyngeal insufficiency) are non-invasive and safety, therefore, many researchers have used it to diagnose the hyper/hyponasality and articulation disorders of cleft palate patients. The purpose of this study was to estimate mainly the oropharyngeal air pressure and over all air flow in cleft lip and palate patients. The pressure-collecting catheter was positioned in the oropharyngel cavity around tongue base. Twelve adult control group and three cleft lip & palate patients were participated to this experimentation. Aerophone II was used to measure peak air flow, mean air flow, phonatory airflow, phonatory efficiency and resistance. The results were as follows: 1) Airflow of cleft lip ＆ palate patients group were higher than those of control group. Fricative sounds /s/ and /s'/ showed the statistic significance of mean airflow and volume data. 2) Intraoral air pressure of cleft lip ＆ palate patients was lower than those of control group.

• Archives of Plastic Surgery
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• v.32 no.5
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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.

• Archives of Plastic Surgery
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• v.39 no.6
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• pp.655-658
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• 2012

Squamous cell carcinoma infrequently occurs at the soft palate. Although various methods can be used for reconstruction of soft palate defects that occur after resecting squamous cell carcinoma, it is difficult to obtain satisfactory results from the perspective of the functional restoration of the soft palate. A combination of bilateral palatal mucomuscular flap for the oral side and superiorly based posterior pharyngeal flap for the nasal side were performed on two patients who were diagnosed with squamous cell carcinoma of the soft palate in order to reconstruct the soft palate defects after surgical resection. After surgery, the patients were followed-up for a mean period of 11 months. The flaps were well maintained in both patients. The donor site defects were epithelialized and completely recovered. Additionally, no recurrence of the primary sites was shown. Slight hyponasality was observed in the voice assessments that were conducted 6 months after surgery. No food regurgitation or aspiration was observed in the swallowing tests. We used a combination of bilateral palatal mucomuscular flap and superiorly based posterior pharyngeal flap to reconstruct the soft palate defects that occurred after resecting the squamous cell carcinomas. We reduced the donor site complications and achieved functionally satisfactory outcomes.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.2
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• pp.53-62
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• 2005

Submucosal type cleft palate is a kind of cleft palate. A submucosal cleft may result in shortening of the anteroposterior dimension of the hard or soft palates or both. The increased distance along with the lack of muscle connection in the soft palate usually accounts for the lack of palatopharyngeal function in patients with submucosal cleft. Resonance disorders which is found in cleft patients show hypernasality or hyponasality. Many cases of submucosal type cleft palate patients visit our clinics due to hypernasality. In this study, resonance disorders was evaluated through nasalance test. Experimental group was composed of submucosal type cleft palate patients. The patients were treated by a so-called combined therapy, i.e., operation and speech training. To observe the changing pattern by surgery, nasalance test was carried out one time before surgery and three times after surgery. Nasometer II was used as a examination. The questionaire was filled with single vowels & diphthongs. The mean nasalance score of the child was significantly lower than that of the adult at every vowel. An early age at operation (under 10 years) was that a better functional result was achieved with patients. The mean nasalance score of /i/ was highest and that of /a/ was the lowest. The result of corrective surgery in selected cases has achieved improvement in all cases. Hypernasality has been consistently diminished. he operation.

• Korean Journal of Cleft Lip And Palate
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• v.11 no.1
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• pp.1-12
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• 2008

In cleft palate patient, characteristic of speech disorder is the resonance disorder result from velopharyngeal incompetence. Clinically VPI caused by congenital factor as congenital palatal incompetence, submucosal cleft palate, and caused by acquired factor as CNS damage, tumor, palatal palsy. The clinicians more concerned about the speech disorders after cleft palate surgery rather than language pathologist. The resonance disorder devided for hypernasality, hyponasality and nasal emission, but as a rule, hypernasality is typical phenomenon of the resonance disorder. Traditionally clinicians and language pathologists evaluated four-stage or five-stage of hypernasality by subjective assessment. Although language pathologist is well-trained, results of the language level should be different. In late 1980s, Kay Elemetrics Corp. developed nasometer that objective nasalance identified with well-trained language pathologist and originate from nasometer Tonar I and II were developed by Fletcher. Therefore objective nasalance test was possible, the nasometer used in hospital, collage and speech clinic both and home and abroad. Standardization of the cleft palate speech assessment must be settled without delay because of different character result in different language and different assessment results by dialect in same language. In our study, we provide the data base for the standardization of cleft palate speech assessment which through report of objective assessment method, speech therapy effects and problems result in interdisciplinary teamwork by nasometer use in treatment of cleft palate patient.

• Speech Sciences
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• v.1
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• pp.237-259
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• 1997

Cleft Palate speech appears to have hyper/hyponasality with velopharyngeal insufficiency and articulation disorders. Previous studies on Cleft Palate speech have shown that speech tends to have lower airflow and air pressure. To examine the aerodynamic characteristics of Cleft Palate speech, Aerophone II Voice function Analyzer was used. We measured sound pressure level, airflow, air pressure and glottal power. Three Cleft Palate adults and five normal adults participated in this experiment. The test words are composed of: (1) the sustained vowel /o/ (2) /CiCi/, where C is one of three different stop consonants in Korean (3) /bimi/. Subjects were asked to produce /bimi/ five times without opening their lips. All the data was statistically tested by t-test for Cleft Palate patients before operation groups and control groups and paired t-test for Cleft Palate patients before and after operation groups. The results were as follow: (1) Cleft Palate patients generally speak with incomplete oral closure and lower oral air pressure. As a result, the SPL of Cleft Palate before operation is 3 dB lower than control groups. (2) Airflow of Cleft Palate in phonation and articulation is lower than that of control groups. However, it increased after operation. Lung volume and mean airflow in phonation are significantly increased (p<0.05). (3) Although velopharyngeal function (velar opening rate) of Cleft Palate is poor in comparison with control groups, it was recovered after operation. In this event maximum flow rate and mean airflow rate are significantly increased (p<0.05). (4) Air pressure of Cleft Palate in speech is lower than that of control groups. In general, the air pressure of Cleft Palate increased after operation. In this event air pressure of glottalized consonant is significantly increased (p<0.04). (5) Glottal Power(mean power, mean efficient and mean resistant) of Cleft Palate patients is lower than that of control groups. But mean efficient and mean resistant of Cleft Palate patients increased significantly (p<0.05) after operation.