Overall intelligibility, articulation, resonance, voice and language in a child with Nager syndrome

Impacts of anterior-posterior jaw disproportions on speech of dentofacial disharmony patients

BACKGROUND/OBJECTIVES

Articulation problems impact communication, development, and quality of life, and are diagnosed in 73-87% of patients with Class II Dentofacial Disharmony (DFD). We evaluated whether differences exist in stop (/t/ or/k/), fricative (/s/ or/ʃ/), and affricate (/tʃ/) consonant sounds of Class II DFD subjects, and whether extent of malocclusion correlates with severity of speech distortion. We hypothesized that Class II patients display milder distortions than Class III and anterior open bite (AOB), as Class II patients can posture into a Class I occlusion.

MATERIALS/METHODS

Audio and orthodontic records were collected from DFD patients (N = 53-Class II, 102-Class III, 72-Controls) who were pursuing orthodontics and orthognathic surgery. A speech pathologist perceptually scored speech. Acoustic differences in recordings were measured using Spectral Moment Analysis.

RESULTS

When Class II subjects were compared to controls, significant differences were found for the centroid frequency (M1) of the /s/ sound and the spectral spread (M2) of /t/, /tʃ/, and /s/ sounds, with pairwise significance for controls relative to Class II AOB and all Class II subjects. Class II AOB subjects had higher M1 and M2 values than patients with Class II closed bites and Class I controls for most sounds. When comparing across anterior-posterior (AP) groups, differences exist between controls, Class II and III DFD subjects for M1 of /t/, /tʃ/, and/ʃ/ and M2 for /t/, /tʃ/, /s/, and /ʃ/ sounds. Using linear regression, correlations between Class II and III severity and spectral measures were found for /t/ and /tʃ/ sounds.

CONCLUSIONS/IMPLICATIONS

Class II and III patients have a higher prevalence of qualitative distortions and spectral changes in consonants compared to controls, but Class II spectral shifts are smaller and affect fewer sounds than in Class III and AOB cohorts. Linear correlations between AP discrepancy and spectral change suggest causation and that treatment may improve articulation problems.

Dental management of a patient with Moebius syndrome: A case report

BACKGROUND

Moebius syndrome (MBS) is a nonprogressive and rare congenital neuromuscular disorder involving the facial nerve and abductor nerve; it mainly manifests as facial paralysis and eye strabismus paralytic symptoms. Tissues in the oral cavity are also compromised, characterized by microstomia, micrognathia, tongue malformation, cleft lip, high arched palate or cleft palate, bifid uvula, and dental malocclusion. Therefore, dentistry plays a fundamental and crucial role in caring for these individuals. However, there is limited available data on MBS treatment, particularly regarding dental management.

CASE SUMMARY

This case report presents dental treatment of a 21-year-old man with MBS and discusses crucial interactions among oral complications of MBS. In this case, the patient was clinically characterized by congenital neuromuscular disorder, occlusal disorders, and tooth and gum problems. It is noteworthy that the patient presented early eruption of deciduous teeth 2 mo after birth, which has not been reported in other MBS cases and suggests a potentially new clinical manifestation of this syndrome. It is important to note that MBS cannot be cured, and oral manifestations of this syndrome can be managed by a multidisciplinary health care team that helps the patient maintain oral hygiene and dental health. After a series of oral treatments, no obvious poor oral hygiene, swollen gums, or abnormal imaging results were observed after 2 years of follow-up.

CONCLUSION

This case addressed the oral clinical manifestations of MBS and difficulties experienced during dental management, and suggested early tooth eruption as a potentially new clinical manifestation of this syndrome. Knowledge of the loop-mediated association among oral complications of this syndrome is essential to perfecting treatments.

Application of linear discriminant analysis to the nasometric assessment of resonance disorders: a pilot study

Objective : Nasalance scores have traditionally been used to assess hypernasality. However, resonance disorders are often complex, and hypernasality and nasal obstruction may co-occur in patients with cleft palate. In this study, normal speakers simulated different resonance disorders, and linear discriminant analysis was used to create a tentative diagnostic formula based on nasalance scores for nonnasal and nasal speech stimuli. Materials and Methods : Eleven female participants were recorded with the Nasometer 6450 while reading nonnasal and nasal speech stimuli. Nasalance measurements were taken of their normal resonance and their simulations of hyponasal, hypernasal, and mixed resonance. Results : A repeated-measures analysis of variance revealed a resonance condition-stimuli interaction effect (P < .001). A linear discriminant analysis of the participants' nasalance scores led to formulas correctly classifying 64.4% of the resonance conditions. When the hyponasal and mixed resonance conditions with obstruction of the less patent nostril were removed from the analysis, the resultant formulas correctly classified 88.6% of the resonance conditions. Conclusion : The simulations produced distinctive nasalance scores, enabling the creation of formulas that predicted resonance condition above chance level. The preliminary results demonstrate the potential of this approach for the diagnosis of resonance disorders.