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Diallo-Hornez G, Khonsari RH, Mercier JM, Delaire J, Balandier S, Defay V, Isidor B, Rousteau G, Talmant JC, Perrin JP, Bertin H, Corre P. Could pharyngeal fat injection be a first-line treatment of velopharyngeal insufficiency? J Stomatol Oral Maxillofac Surg 2022; 123:e206-e211. [PMID: 34844018 DOI: 10.1016/j.jormas.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/23/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Garance Diallo-Hornez
- Clinique de Chirurgie Maxillo-faciale et de Stomatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Roman Hossein Khonsari
- Hôpital Necker Enfants - Malades, Service de Chirurgie Maxillo-faciale et Chirurgie Plastique, Assistance Publique - Hôpitaux de Paris, Université de Paris , Paris, France
| | - Jacques-Marie Mercier
- Clinique de Chirurgie Maxillo-faciale et de Stomatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Jean Delaire
- Clinique de Chirurgie Maxillo-faciale et de Stomatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Sophie Balandier
- Clinique de Chirurgie Maxillo-faciale et de Stomatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Virginie Defay
- Clinique de Chirurgie Maxillo-faciale et de Stomatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Bertrand Isidor
- Service de Génétique clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Gabriel Rousteau
- Clinique de Chirurgie Maxillo-faciale et de Stomatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Jean-Claude Talmant
- Chirurgie Plastique, Reconstructrice et Esthétique, Clinique Jules Verne, Nantes, France
| | - Jean-Philippe Perrin
- Clinique de Chirurgie Maxillo-faciale et de Stomatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Hélios Bertin
- Clinique de Chirurgie Maxillo-faciale et de Stomatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Pierre Corre
- Clinique de Chirurgie Maxillo-faciale et de Stomatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France.
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Hahm J, Bressmann T. Effects of different calibration schedules on the test-retest differences of nasalance scores obtained with the Nasometer 6450. Clin Linguist Phon 2022; 36:292-300. [PMID: 34554041 DOI: 10.1080/02699206.2021.1974094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
Nasometry is used to assess nasality in speech but it is unclear whether overly frequent recalibration of the instrument adds measurement errors. The goal of the present research study was to describe the effect of the Nasometer 6450 calibration on the nasalance scores of repeated recordings. In a first experiment, the Nasometer calibration values stored in the computer's registry were manipulated to investigate the impact on nasalance scores. In the second experiment, a set of pre-recorded speech samples was re-recorded 40 times with a Nasometer 6450 in 4 different calibration regimens: Short-term repeated recordings without (R1) and with recalibration (R2C), and long-term repeated recordings over 10 days without (R3) and with recalibration (R4C). The first experiment showed that, compared to a calibration value of 1.0, a value of 0.9 resulted in nasalance scores that were on average 3 points lower while a calibration value of 1.1 resulted in scores that were 0.5 points higher. The results of the second experiment showed test-retest differences of less than 2 nasalance points for 91% of the data for a non-nasal stimulus. For a nasal stimulus, 91% of data were within 5 points for R3 and R4C. The results suggested that frequent recalibration of the Nasometer may slightly increase test-retest differences of nasalance scores. An alternative procedure for verifying microphone balance without recalibration is suggested.
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Affiliation(s)
- Jennifer Hahm
- Department of Speech-Language Pathology, University of Toronto, Toronto, Canada
- Department of Rehabilitation and Special Education, University of Cologne, Cologne, Germany
| | - Tim Bressmann
- Department of Speech-Language Pathology, University of Toronto, Toronto, Canada
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Fitzpatrick B, Panagamuwa C, Moss Levy L, Rihtman T. The impact of hearing loss on speech outcomes in 5-year-old children with cleft palate ± lip: A longitudinal cohort study. Int J Pediatr Otorhinolaryngol 2021; 149:110870. [PMID: 34385041 DOI: 10.1016/j.ijporl.2021.110870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/19/2021] [Accepted: 08/04/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To investigate the impact of hearing loss (using longitudinal measurements of hearing) on speech outcomes at age 5 (5 years 0 months-5 years 11 months) in children born with cleft palate ± lip. Other variables which may impact upon the speech outcomes at age 5 in this population were also investigated. METHODS A retrospective longitudinal cohort study of children, without a named syndrome, born with cleft palate ± lip, and treated at a Cleft Centre in the United Kingdom. Data collected from infancy to 5 years 11 months, included hearing test results from three specific time points (7 months-1 year 2 months [age A]; 2 years 0 months-2 years 11 months [age B]; 5 years 0 months-5 years 11 months [age C]) and speech outcome data at age 5 years (5 years 0 months-5 years 11 months). Hearing test results at each age were compared to identify how hearing changes with age. Correlations between hearing test results and speech outcomes at age 5 were analysed. RESULTS Hearing loss was frequent but predominantly mild. There were no significant correlations between speech outcomes and hearing results at any age. Mild hearing loss remained prevalent at age 5, although a significant age-related hearing improvement was found. A significant relationship between cleft type and cleft speech characteristics was found (P < .001); children with Bilateral Cleft Lip and Palate achieved the poorest articulation outcomes. CONCLUSION Although mild hearing loss was common in the cohort, there was no association between hearing loss and the speech outcomes investigated. In contrast, the type of cleft was significantly associated with the presence of cleft speech characteristics. Further longitudinal measurement of hearing is required to substantiate the findings of this study.
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Bakhshaee M, Jahanian M, Khazaeni K, Sobhani D, Mashhadi L, Rasoulian B. Potential Effects of Rhinoplasty on Voice in Professional Voice Users. Aesthetic Plast Surg 2021; 45:2280-2286. [PMID: 33876285 DOI: 10.1007/s00266-021-02250-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIM Surgical procedures involving the manipulation of the airway structure have the potential to affect the quality of voice by changing the resonance properties. Regarding this, the present study was conducted to investigate the effect of rhinoplasty on the voice of professional voice users. METHODS AND MATERIALS This cohort study was conducted on 30 professional voice users. For the purpose of the study, the patients completed the Voice Handicap Index (VHI). In addition, they were subjected to voice analysis that included the measurement of nasality in speech production (i.e., nasalance), using the nasometer II. Computerized speech lab was also utilized to examine vowels /e/ and /a/, each of which was sustained for 5 sec by the participants. RESULTS The mean VHI scores were 8.5 ± 1.98 and 7.36 ± 1.71 before and after the surgery, respectively, indicating no significant difference between the two investigated stages (Z = - 0.53, P = 0.59). However, there was a significant difference between the patients with and without preoperative obstruction in terms of the VHI score (χ2 = 11.06, P = 0.004). With regard to orality, it had the mean values of 16.86 ± 7.45 and 15.22 ± 7.37 before and after the surgery, respectively. Furthermore, the mean values of nasality at the pre- and post-operation stages were 59.42 ± 6.04 and 56.28 ± 10.07, respectively. The comparison between the pre- and post-surgical orality and nasality revealed no significant difference (t = 1.226, P = 0.23 and t = 0.93, P = 0.36, respectively). CONCLUSION Although rhinoplasty is supposed to affect voice and vocal resonation, the induced changes are not problematic for the professional voice users. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Yang KL, Luo SD, Tsai MH, Chang Y, Kuo HY, Chen WC. Nasality outcome in unilateral chronic rhinosinusitis following functional endoscopic sinus surgery. J Formos Med Assoc 2021; 121:936-942. [PMID: 34281727 DOI: 10.1016/j.jfma.2021.06.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND/PURPOSE In this study we aimed to investigate the prevalence of abnormal nasality in patients with unilateral rhinosinusitis and their nasality outcomes following functional endoscopic sinus surgery (FESS). METHODS A total of 42 patients with unilateral chronic rhinosinusitis who underwent unilateral FESS between April 2016 and November 2017 were enrolled. Questionnaires on sinonasal symptoms and nasality were recorded. The change in the nasalance score of vowels [a], [i] [u], nasal consonant [m], 2 nasal syllable repetitions, and 2 Chinese sentences were measured. The patients were evaluated preoperatively, 6 months, and 12 months after the operation. The patients were divided into two groups, wide opening surgery and limited surgery, according to the severity of the disease. RESULTS Among 42 patients, the subjective reports showed that one-third of unilateral chronic rhinosinusitis (CRS) patients had abnormal nasality preoperatively and significant improvement following FESS. The Lund-Mackay score was significantly negatively correlated with preoperative nasalance of [i] and positively correlated with change of nasalance of [i]. The increase in the value of [i] is statistically significant (p = 0.01) following FESS. In the further subgroup analysis, the change in nasalance was significant in the wide opening surgery group, but not in the limited surgery group. CONCLUSION Although only one side of the nasal airway was involved, one-third of the patients reported abnormal nasality. In patients with more disease severity who underwent wide opening surgery, the nasalance significantly increased 1 year after FESS. The increase in the objective nasalance score was corresponded to a significant improvement of subjective self-reported nasality assessment postoperatively.
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Affiliation(s)
- Kun-Lin Yang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng-Dean Luo
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Hsien Tsai
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Tajen University College of Pharmacy and Health Care, Pingtung, Taiwan
| | - Yi Chang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Center of Audiology and Speech-language Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Huei-Yi Kuo
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Chih Chen
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Tajen University College of Pharmacy and Health Care, Pingtung, Taiwan.
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Vanpoucke B, Cosyns M, Bettens K, Van Borsel J. Nasality in Homosexual Men: A Comparison with Heterosexual Men and Women. Arch Sex Behav 2019; 48:1443-1449. [PMID: 30232654 DOI: 10.1007/s10508-018-1306-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 06/14/2018] [Accepted: 09/05/2018] [Indexed: 06/08/2023]
Abstract
Several studies reported that pitch and articulation may vary according to a person's sexual orientation. The purpose of this study was to investigate whether homosexual males also demonstrate differences in nasal resonance compared to heterosexual males. Speech samples of 30 self-identified homosexual males, 35 heterosexual males, and 34 heterosexual females were compared both instrumentally and perceptually. Nasalance scores were calculated for the sounds /a/, /i/, /u/, and /m/ and for an oronasal, oral, and nasal text. In addition, the Nasality Severity Index was determined. Spontaneous speech samples were used for a perceptual evaluation of nasal resonance. Neither the nasalance scores nor the Nasality Severity Index were significantly different between the homosexual and heterosexual males. Heterosexual females, on the other hand, showed significantly higher nasalance values for the oronasal and oral text and a significantly lower Nasality Severity Index than both the homosexual and the heterosexual males. The perceptual judgment revealed no significant differences between the three groups. The results of this study suggest that, in contrast to pitch and articulation, nasality does not tend to vary with sexual orientation.
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Affiliation(s)
- Belle Vanpoucke
- Logopaedic and Audiological Sciences, Ghent University, UZ Gent 2P1, De Pintaan 185, 9000, Ghent, Belgium
| | - Marjan Cosyns
- Logopaedic and Audiological Sciences, Ghent University, UZ Gent 2P1, De Pintaan 185, 9000, Ghent, Belgium
| | - Kim Bettens
- Logopaedic and Audiological Sciences, Ghent University, UZ Gent 2P1, De Pintaan 185, 9000, Ghent, Belgium
| | - John Van Borsel
- Logopaedic and Audiological Sciences, Ghent University, UZ Gent 2P1, De Pintaan 185, 9000, Ghent, Belgium.
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Zaer S, Felix I, Amstutz Montadert I, Vivier PH, Bon-Mardion N, Marie JP. Retropharyngeal lipostructure in the treatment of velopharyngeal insufficiency: A prospective study and update. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:173-177. [PMID: 30902555 DOI: 10.1016/j.anorl.2019.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Retropharyngeal lipostructure is a recent procedure in velopharyngeal insufficiency (VPI), offering an effective alternative to heavier surgery. OBJECTIVES To update and assess retropharyngeal lipostructure as a treatment for VPI in the University Hospital Center of Rouen (France). TYPE OF STUDY Single-center prospective study, from May 2012 to May 2014. PATIENTS AND METHODS Six patients (4 girls, 2 boys) presenting with VPI were treated by retropharyngeal lipostructure. Age at surgery ranged between 6 and 12 years. Four of the patients bore a 22q11 microdeletion. Treatment was indicated in case of Borel-Maisonny type 2b (n=2) or 2m (n=4) despite well-conducted speech therapy and of≥50% velopharyngeal sphincter closure on nasal endoscopy. Patients were assessed preoperatively and at 3 months, by a multidisciplinary team. Borel-Maisonny type was assessed by a speech therapist. Nasality was measured on assisted vocal evaluation (EVA®). Sphincter closure was assessed on dynamic MRI. RESULTS Between 6 and 8cm3autologous fat was injected. At 3months, 4 children showed 1-grade improvement in Borel-Maisonny type. Nasality decreased systematically, from a mean 14.5% preoperatively to 10.5% postoperatively. MRI showed improvement in all cases, with complete closure in occlusive vowels in 3 children. CONCLUSION EVA® and MRI provide precise objective assessment of VPI. Retropharyngeal lipostructure is a simple, relatively non-invasive, reproducible technique, providing good results in VPI.
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Affiliation(s)
- S Zaer
- Service d'ORL et chirurgie cervico-faciale, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
| | - I Felix
- Service d'ORL et chirurgie cervico-faciale, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France
| | - I Amstutz Montadert
- Service d'ORL et chirurgie cervico-faciale, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France
| | - P-H Vivier
- Service d'imagerie médicale, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France
| | - N Bon-Mardion
- Service d'ORL et chirurgie cervico-faciale, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France
| | - J-P Marie
- Service d'ORL et chirurgie cervico-faciale, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France
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Sinko K, Gruber M, Jagsch R, Roesner I, Baumann A, Wutzl A, Denk-Linnert DM. Assessment of nasalance and nasality in patients with a repaired cleft palate. Eur Arch Otorhinolaryngol 2017; 274:2845-2854. [PMID: 28299425 PMCID: PMC5486565 DOI: 10.1007/s00405-017-4506-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 02/10/2017] [Indexed: 01/27/2023]
Abstract
In patients with a repaired cleft palate, nasality is typically diagnosed by speech language pathologists. In addition, there are various instruments to objectively diagnose nasalance. To explore the potential of nasalance measurements after cleft palate repair by NasalView®, we correlated perceptual nasality and instrumentally measured nasalance of eight speech items and determined the relationship between sensitivity and specificity of the nasalance measures by receiver-operating characteristics (ROC) analyses and AUC (area under the curve) computation for each single test item and specific item groups. We recruited patients with a primarily repaired cleft palate receiving speech therapy during follow-up. During a single day visit, perceptive and instrumental assessments were obtained in 36 patients and analyzed. The individual perceptual nasality was assigned to one of four categories; the corresponding instrumental nasalance measures for the eight specific speech items were expressed on a metric scale (1-100). With reference to the perceptual diagnoses, we observed 3 nasal and one oral test item with high sensitivity. However, the specificity of the nasality indicating measures was rather low. The four best speech items with the highest sensitivity provided scores ranging from 96.43 to 100%, while the averaged sensitivity of all eight items was below 90%. We conclude that perceptive evaluation of nasality remains state of the art. For clinical follow-up, instrumental nasalance assessment can objectively document subtle changes by analysis of four speech items only. Further studies are warranted to determine the applicability of instrumental nasalance measures in the clinical routine, using discriminative items only.
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Affiliation(s)
- Klaus Sinko
- Department of Cranio-, Maxillofacial and Oral Surgery, Medical University, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Maike Gruber
- Department of Cranio-, Maxillofacial and Oral Surgery, Medical University, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Reinhold Jagsch
- Faculty of Psychology, Institute of Clinical Psychology, University of Vienna, Vienna, Austria
| | - Imme Roesner
- Division of Phonatrics-Logopedics, Department of Otorhinolaryngology, Medical University, Vienna, Austria
| | - Arnulf Baumann
- Department of Cranio-, Maxillofacial and Oral Surgery, Medical University, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Arno Wutzl
- Department of Cranio-, Maxillofacial and Oral Surgery, Medical University, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Doris-Maria Denk-Linnert
- Division of Phonatrics-Logopedics, Department of Otorhinolaryngology, Medical University, Vienna, Austria
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Novotný M, Rusz J, Čmejla R, Růžičková H, Klempíř J, Růžička E. Hyper nasality associated with basal ganglia dysfunction: evidence from Parkinson's disease and Huntington's disease. PeerJ 2016; 4:e2530. [PMID: 27703866 PMCID: PMC5047145 DOI: 10.7717/peerj.2530] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/04/2016] [Indexed: 11/20/2022] Open
Abstract
Background Although increased nasality can originate from basal ganglia dysfunction, data regarding hypernasality in Parkinson’s disease (PD) and Huntington’s disease (HD) are very sparse. The aim of the current study was to analyze acoustic and perceptual correlates of velopharyngeal seal closure in 37 PD and 37 HD participants in comparison to 37 healthy control speakers. Methods Acoustical analysis was based on sustained phonation of the vowel /i/ and perceptual analysis was based on monologue. Perceptual analysis was performed by 10 raters using The Great Ormond Street Speech Assessment ’98. Acoustic parameters related to changes in a 1/3-octave band centered on 1 kHz were proposed to reflect nasality level and behavior through utterance. Results Perceptual analysis showed the occurrence of mild to moderate hypernasality in 65% of PD, 89% of HD and 22% of control speakers. Based on acoustic analyses, 27% of PD, 54% of HD and 19% of control speakers showed an increased occurrence of hypernasality. In addition, 78% of HD patients demonstrated a high occurrence of intermittent hypernasality. Further results indicated relationships between the acoustic parameter representing fluctuation of nasality and perceptual assessment (r = 0.51, p < 0.001) as well as the Unified Huntington Disease Rating Scale chorea composite subscore (r = 0.42, p = 0.01). Conclusions In conclusion the acoustic assessment showed that abnormal nasality was not a common feature of PD, whereas patients with HD manifested intermittent hypernasality associated with chorea.
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Affiliation(s)
- Michal Novotný
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague , Prague , CZ , Czech Republic
| | - Jan Rusz
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, CZ, Czech Republic; Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, CZ, Czech Republic
| | - Roman Čmejla
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague , Prague , CZ , Czech Republic
| | - Hana Růžičková
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague , Prague , CZ , Czech Republic
| | - Jiří Klempíř
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, CZ, Czech Republic; Institute of Anatomy, First Faculty of Medicine, Charles University in Prague, Prague, CZ, Czech Republic
| | - Evžen Růžička
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague , Prague , CZ , Czech Republic
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Baudonck N, Van Lierde K, D'haeseleer E, Dhooge I. Nasalance and nasality in children with cochlear implants and children with hearing aids. Int J Pediatr Otorhinolaryngol 2015; 79:541-5. [PMID: 25677563 DOI: 10.1016/j.ijporl.2015.01.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 01/20/2015] [Accepted: 01/22/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In prelingually deaf children, many speech production aspects including resonance, are known to be problematic. This study aimed to investigate nasality and nasalance in two groups of prelingually hearing impaired children, namely deaf children with a cochlear implant (CI) and moderate-to-severely hearing impaired hearing aid (HA) users. The results of both groups are compared with the results of normal hearing children. Besides, the impact of the degree of hearing loss was determined. METHODOLOGY 36 CI children (mean age: 9;0y), 25 HA children (mean age: 9;1y) and 26 NH children (mean age: 9;3y) were assessed using objective assessment techniques and perceptual evaluations in order to investigate the nasal resonance of the three groups. Ten HA children had thresholds above 70dB (range: 91dB-105dB) and fifteen below 70dB (range: 58dB-68dB). The Nasometer was used for registration of the nasalance values and nasality was perceptually evaluated by two experienced speech therapists using a nominal rating scale (consensus evaluation). RESULTS For nasal stimuli, both CI children and HA children showed lower nasalance values in comparison with NH children. The opposite was observed for the oral stimuli. In both hearing impaired groups, cul-de-sac-resonance was observed on a significantly larger scale than in the NH group, and the HA children were judged to be significantly more hypernasal in comparison with NH children. CONCLUSIONS Despite the fact that a substantial number of the CI and HA children demonstrate normal (nasal) resonance quality, this aspect of speech production is still at risk for hearing impaired children.
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Affiliation(s)
- N Baudonck
- Ghent University Hospital, Department of Otorhinolaryngology, Audiology and Logopaedics, and Center for Ambulant Hearing and Speech Rehabilitation "Ter Sprake", de Pintelaan 185, B-9000 Ghent, Belgium.
| | - K Van Lierde
- Ghent University, Department of Speech, Language and Hearing Sciences, de Pintelaan 185, B-9000 Ghent, Belgium
| | - E D'haeseleer
- Ghent University, Department of Speech, Language and Hearing Sciences, de Pintelaan 185, B-9000 Ghent, Belgium
| | - I Dhooge
- Ghent University Hospital, Department of Otorhinolaryngology, Audiology and Logopaedics, and Center for Ambulant Hearing and Speech Rehabilitation "Ter Sprake", de Pintelaan 185, B-9000 Ghent, Belgium; Ghent University, Department of Otorhinolaryngology, de Pintelaan 185, B-9000 Ghent, Belgium
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Bettens K, Wuyts FL, Van Lierde KM. Instrumental assessment of velopharyngeal function and resonance: a review. J Commun Disord 2014; 52:170-183. [PMID: 24909583 DOI: 10.1016/j.jcomdis.2014.05.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 04/14/2014] [Accepted: 05/16/2014] [Indexed: 06/03/2023]
Abstract
UNLABELLED The purpose of this literature review is to describe and discuss instrumental assessment techniques of the velopharyngeal function in order to diagnose velopharyngeal disorders and resonance characteristics. Both direct and indirect assessment techniques are addressed, in which successively nasopharyngoscopy, videofluoroscopy, magnetic resonance imaging (MRI), cephalometric radiographic analysis, computed tomography (CT), ultrasound, acoustic and aerodynamic measurements are considered. Despite the multiple instrumental assessments available to detect and define velopharyngeal dysfunction, the ideal technique is not yet accessible. Therefore, a combination of different quantitative parameters can possibly form a solution for a more reliable determination of resonance disorders. These multi-dimensional approaches will be described and discussed. The combination of quantitative measurement techniques and perceptual evaluation of nasality will probably remain necessary to provide sufficient information to make appropriate decisions concerning the diagnosis and treatment of resonance disorders. LEARNING OUTCOMES The reader will be able to describe and discuss currently available instrumental techniques to assess the velopharyngeal mechanism and its functioning in order to diagnose velopharyngeal disorders. Additionally, he will be able to explain the possible advantages of the combination of several types of complementary measurement techniques.
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Affiliation(s)
- Kim Bettens
- Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium.
| | - Floris L Wuyts
- Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium; Biomedical Physics, University of Antwerp, Antwerp, Belgium
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Kim EY, Yoon MS, Kim HH, Nam CM, Park ES, Hong SH. Characteristics of nasal resonance and perceptual rating in prelingual hearing impaired adults. Clin Exp Otorhinolaryngol 2012; 5:1-9. [PMID: 22468195 DOI: 10.3342/ceo.2012.5.1.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2011] [Revised: 12/21/2011] [Accepted: 12/28/2011] [Indexed: 11/11/2022] Open
Abstract
Objectives Resonance problems in hearing impaired (HI) individuals have been described as aspects of nasality. However, there are limitations in being able to explain the range of resonance problems. Therefore, this study suggests a perceptual rating that will effectively explain the characteristics of resonance problems in HI individuals. Methods Nasalance scores were obtained from 32 subjects in each of HI and normal hearing (NH) groups using a nasometer. The subjects were categorized into groups based on normal and abnormal nasalance ranges. The abnormal nasalance range group was further divided into hyper-, hypo-, and mixed-nasal groups. Nasalance scores were based the individuals performance in a series of passage and syllable tasks. The perceptual rating was evaluated using a newly introduced tool, 'vertical focus of resonance' (VFR), which focuses on the resonance energy in the frontal, throat, pharyngeal and nasal locations. Results The NH group demonstrated a significantly lower nasalance score in the oral coupling and passage tasks than the HI group. Based on the results of nasalance correlation analysis, the HI group showed highly significant correlations between syllable and passage tasks, as contrasted with the NH group. There were significant differences in VFR between the nasalance types in both the NH and the HI groups. Conclusion The HI hyper-nasal group showed tendencies of velopharyngeal opening, as opposed to the HI hypo-nasal group which showed tendencies of velopharyngeal closure. The HI mixed-nasal group showed inappropriate coordination of velopharyngeal function. In the HI group, the results of VFR showed that the air flow and the resonance energy were not released from the cavity of resonance. The suggested VFR tool explains the focusing characteristics of resonance energy within a continuation of speech sound regardless of the phonetic environment. Therefore, VFR may be a useful tool in explaining the deviant resonance patterns of HI individuals.
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