Immediate and sustained changes in tongue movement with an experimental palatal "fistula": a case study

Nasalance and nasality at experimental velopharyngeal openings in palatal prosthesis: a case study

The use of prosthetic devices for correction of velopharyngeal insufficiency (VPI) is an alternative treatment for patients with conditions that preclude surgery and for those individuals with a hypofunctional velopharynx (HV) with a poor prognosis for the surgical repair of VPI. Understanding the role and measuring the outcome of prosthetic treatment of velopharyngeal dysfunction requires the use of tools that allow for documenting pre- and post-treatment outcomes. Experimental openings in speech bulbs have been used for simulating VPI in studies documenting changes in aerodynamic, acoustic and kinematics aspects of speech associated with the use of palatal prosthetic devices. The use of nasometry to document changes in speech associated with experimental openings in speech bulbs, however, has not been described in the literature.

Spectral findings for vowels [a] and [ã] at different velopharyngeal openings

BACKGROUND

The size control of velopharyngeal opening is an important variable for the acoustic profile characterization of hypernasal speech.

AIM

To investigate frequency spectral aspects of F1, F2, F3, nasal formant (FN) and anti-formant, in Hertz, for vowels [a] and [ã] at different velopharyngeal openings produced in the bulb of a palatal prosthesis replica used by a patient with velopharyngeal insufficiency.

METHOD

Speech recordings were obtained for four words ("pato/mato" and "panto/manto") produced within a carrier phrase in 5 conditions of velopharyngeal functioning: prosthesis with no openings (control condition: CC); prosthesis with bulb opening of 10 mm² (experimental condition with 10 mm² opening: EC10), prosthesis with a 20 mm² opening (EC20), prosthesis with a 30 mm² opening (EC30), and without the prosthesis (ECO). Five speech-language pathologists made a live rating of speech nasality during the reading of an oral passage. The recordings were used for spectral analysis.

RESULTS

F1 values were significantly higher for [a] when compared to [ã] in all conditions. F2 values for [a] in EC20 and EC30 were significantly lower than values in the other conditions, being closer to the values presented for [ã]. F3 values were not significantly different between the testing conditions. There was a relationship between FN and anti-formants, and the auditory perception of nasality for conditions EC10 and EC20.

CONCLUSION

Significant changes were observed in the studied spectral values according to changes in the velopharyngeal opening size.

Articulação compensatória associada à fissura de palato ou disfunção velofaríngea: revisão de literatura

TEMA: articulação compensatória na fissura palatina. OBJETIVO: contribuir para o aprofundamento de informações sobre os tipos de articulação compensatória descritos na literatura e, ainda, discutir as implicações e contribuições da avaliação clínica e instrumental na identificação destas produções. CONCLUSÃO: as articulações compensatórias merecem a atenção de clínicos e pesquisadores que atuam no Brasil, já que estas alterações são encontradas com grande freqüência em crianças e adultos com fissura palatina ou disfunção velofaríngea, o que compromete a qualidade de vida destes sujeitos. Os fonoaudiólogos devem aprofundar seus conhecimentos sobre os tipos de articulação compensatória e os procedimentos de avaliação, bem como devem estabelecer programas preventivos que favoreçam a aquisição fonológica sem o desenvolvimento dessas compensações.

A preoperative appliance for a newborn with cleft palate

Cleft palate is a commonly observed congenital maxillofacial defect. One of the most important problems with clefts is the interference with feeding. An affected infant cannot produce negative pressure in the oral cavity and therefore cannot move the bolus backward to the pharynx. To obtain better nutritional intake prior to surgical correction, a palatal lift obturator is recommended. In this clinical report, a modified technique of obturator fabrication is presented. The new method uses a piece of tulle, a flexible and durable material that is frequently used in theater attire. With the help of this material, the bulb part is connected to the plate as a labile piece, and this connection acts like a natural velopharyngeal extension. Additionally, because of the softer property of the silicone elastomer, the posterior pharyngeal wall is less irritated.