The relationship between nasalance and velopharyngeal closure status after cleft palate surgery

doi:10.19438/j.cjoms.2023.04.009

Abstract

Abstract: PURPOSE: To investigate the relationship between nasalization rate and palatopharyngeal closure in patients with secondary structural speech disorder after cleft palate surgery. METHODS: A total of 407 speech samples of patients with postoperative cleft palate speech disorders without speech substitution from the Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University were included. The nasal sound meter and nasopharyngeal fiber endoscope were used to record the nasal phonation rate and the score of nasopharyngeal fiber endoscopic visual analog scale (VAS) of the speech samples. The nasal phonation rate values and VAS values were compared by Pearson analysis. SPSS 13.0 software package was used for data analysis. RESULTS: There was negative correlation between nasal phonetic rate and VAS value of 407 speech samples. Velopharyngeal insufficiency was worse, and nasal phonetic rate was higher. There was a significant negative correlation between nasal phonetic rate and VAS value of 296 non-nasal speech samples. According to VAS values of 296 non-nasal speech samples, it suggested if nasalance scores was below 30%, complete or marginal velopharyngeal closure was considered. If nasalance scores is between 30% and 50%, mild velopharyngeal impairment should be considered. If nasalance scores was over 50%, medium or severe velopharyngeal impairment should be considered. CONCLUSIONS: The study showed nasometer can give a clue preliminarily of the velopharyngeal closure status in patients with hypernasality and nasal air emission objectively.

Key words: Cleft palate, Velopharyngeal insufficiency, Nasalance, Nasopharyngeal fiber endoscopy

CLC Number:

R782.2

GAO Tao, MA Lian, LUO Yi, SUN Yong-gang. The relationship between nasalance and velopharyngeal closure status after cleft palate surgery[J]. China Journal of Oral and Maxillofacial Surgery, 2023, 21(4): 372-376.

References

[1] Sousa AD, Devare S, Ghanshani J.Psychological issues in cleft lip and cleft palate[J]. J Indian Assoc Pediatr Surg, 2009, 14(2): 55-58.
[2] Meier JD, Muntz HR.Velopharyngeal dysfunction evaluation and treatment[J]. Facial Plast Surg Clin North Am, 2016, 24(4): 477-485.
[3] Park YH, Jo HJ, Hong IS, et al.Treatment of velopharyngeal insufficiency in a patient with a submucous cleft palate using a speech aid: the more treatment options, the better the treatment results[J]. Maxillofac Plast Reconstr Surg, 2019, 41(1): 19-24.
[4] Shin YJ, Kim Y, Kim HG.The comparative study of resonance disorders for Vietnamese and Korean cleft palate speakers using nasometer[J]. Maxillofac Plast Reconstr Surg, 2017, 39(1): 9-13.
[5] Rabah SM, Alkahtani FS, Jarman A, et al.Effectiveness of the superiorly based pharyngeal flap in treating velopharyngeal insufficiency[J]. Plast Reconstr Surg Glob Open, 2022, 10(12): e4696.
[6] Carvajal álvarez DC, Palomares-Aguilera MM, Meneses Geldres MB, et al.Primary palatal surgery in nonsyndromic cleft palate children and velopharyngeal insufficiency correction outcomes[J]. J Craniofac Surg, 2021, 32(2): 698-704.
[7] 高涛, 马莲, 罗奕, 等. 视觉模拟评分法评价腭裂术后无声状态下腭咽闭合状态的研究[J].中华口腔医学杂志, 2012, 47(7): 419-422.
Gao T, Ma L, Luo Y, et al.Assessment of velopharyngeal status of postoperative cleft palate patients in silent mode by visual analog scale[J]. Chinese Journal of Stomatology, 2012, 47(7): 419-422.
[8] 任延方, 王光和. 腭裂术后腭咽闭合不全的诊断[J]. 中华口腔医学杂志, 1992, 27(1): 9-11.
Ren YF, Wang GH.Diagnosis of velopharyngeal insufficency after surgery of cleft palate[J]. Chinese Journal of Stomatology, 1992, 27(1): 9-11.
[9] Naran S, Ford M, Losee JE.What's new in cleft palate and velopharyngeal dysfunction management?[J]. Plast Reconstr Surg, 2017, 139(6): 1343e-1355e.
[10] Denegri MA, Silva PP, Pegoraro-Krook MI, et al.Cephalometric predictors of hypernasality and nasal air emission[J]. J Appl Oral Sci, 2021, 29: e20210320.
[11] Kollara L, Perry JL.Effects of gravity on the velopharyngeal structures in children using upright magnetic resonance imaging[J]. Cleft Palate Craniofac J, 2014, 51(6): 669-676.
[12] Perry JL, Kuehn DP, Sutton BP, et al.Craniometric and velopharyngeal assessment of infants with and without cleft palate[J]. J Craniofac Surg, 2011, 22(2): 499-503.
[13] Perry JL, Kuehn DP, Sutton BP, et al.Anthropometric analysis of the velopharynx and related craniometric dimensions in three adult populations using MRI[J]. Cleft Palate Craniofac J, 2016, 53(1): e1-e13.
[14] Medeiros-Santana MN, Perry JL, Yaedú RY, et al.Predictors of velopharyngeal dysfunction in individuals with cleft palate following surgical maxillary advancement: clinical and tomographic assessments[J]. Cleft Palate Craniofac J, 2019, 56(10): 1314-1321.
[15] 谭洁, 何凌, 唐铭, 等. 腭裂术后腭咽闭合不全患者声门塞音自动识别[J]. 计算机工程与设计, 2016, 37(8): 2264-2270.
TAN Jie, HE Ling, TANG Ming, et al.Automatic detection of glottal stop from cleft palate patients with incomplete velopharyngeal after cleft palate surgery[J]. Computer Engineering and Design, 2016, 37(8): 2264-2270.
[16] Bakhshaee M, Jahanian M, Khazaeni K, et al.Potential effects of rhinoplasty on voice in professional voice users[J]. Aesthetic Plast Surg, 2021, 45(5): 2280-2286.
[17] Hsieh LC, Lee GS, Lee KS, et al.Hypernasality after the endoscopic modified Lothrop procedure for refractory frontal sinusitis[J]. Int Forum Allergy Rhinol, 2021, 11(8): 1260-1263.
[18] Odeh OM, Madison CL, Riski JE.Nasalance in arabic-speaking jordanians: a comparative study[J]. Folia Phoniatr Logop, 2020, 72(5): 370-377.
[19] Nguyen VT, Lehes L, Truong TTH, et al.Normative nasalance scores for vietnamese-speaking children[J]. Logoped Phoniatr Vocol, 2019, 44(2): 51-57.
[20] Sampaio-Teixeira ACM, Oliveira DN, Yamashita RP, et al.Normative nasalance scores in the production of words and syllables for Brazilian Portuguese speakers[J]. Clin Linguist Phon, 2019, 33(12): 1139-1148.
[21] Alfwaress F, Kummer AW, Weinrich B.Nasalance scores for normal speakers of American English obtained by the nasometer II using the MacKay-Kummer SNAP-R test[J]. Cleft Palate Craniofac J, 2022, 59(6): 765-773.
[22] 高涛, 马莲, 罗奕, 等. 鼻音计在不同时间普通话成人语音评价中稳定性的研究[J]. 北京口腔医学, 2013, 21(1): 40-43.
Gao T, Ma L, Luo Y, et al.Nasometer stability for evaluating the Mandarin adult speech at different time intervals[J]. Beijing Jouurnal of Stomatol, 2013, 21(1): 40-43.
[23] 高涛, 马莲, 罗奕, 等. 声门塞音对鼻音计评价腭咽闭合状态的影响[J].中华口腔医学杂志, 2020, 55(12): 958-962.
Gao T, Ma L, Luo Y, et al.Influence of glottal stops on nasalance and velopharyngeal closure status after cleft palate surgery[J]. Chinese Journal of Stomatology, 2020, 55(12): 958-962.
[24] Garcia AF, Marino VC, Pegoraro-Krook MI, et al.Nasalance during use of pharyngeal and glottal place of production[J]. Codas, 2014, 26(5): 395-401.