Normative nasalance scores in Chilean adults / Valores normativos de nasalancia en adultos chilenos

ABSTRACT Purpose The present study is aimed towards determining and comparing normative nasalance scores in Chilean Spanish-speaking adult men and women. Methods 40 women (age range 18 to 35, X = 25.79, SD = 5.83) and 36 men (age range 18 to 35, X = 26.45, SD = 4.08) were invited to participate, all of them without any previous speech therapy, neurological pathologies, intellectual deficits, hearing loss, syndromes, or other diagnosed pathologies that could impact speech production. A study of proper velopharyngeal function was performed, using a perceptual resonance evaluation. Nasalance was determined using a model 6450 Nasometer, during the reading of three standardized speech samples in Spanish: a nasal passage (NP), an oronasal passage (ONP), and an oral passage (OP). Also, the nasalance distance was calculated. Genders were compared using Wilcoxon tests for independent samples. Results The NP presented the highest percentage of nasalance, with 52.13% (± 4.73), followed by the ONP with 25.38% (± 3.7), and finally the OP, which presented the lowest value of 14.15% (± 5.03). Meanwhile, nasalance distance was 37.98% (± 5.32). Finally, no significant differences were observed when comparing the nasalance between genders (p >0.05). Conclusion The nasalance values obtained were similar to those observed for other Spanish speakers. Also, male and women showed similar scores. The results of this study are a contribution to the indirect assessment of velopharyngeal function in Chilean adults.

RESUMEN Objetivo El presente estudio tiene como objetivo determinar y comparar puntajes normativos de nasalancia en hombres y mujeres chilenos de habla hispana. Método Participaron 40 mujeres (rango de edad de 18 a 35, X = 25.79, DE = 5.83) y 36 hombres (rango de edad de 18 a 35, X = 26.45, DE = 4.08), todos sin ningún antecedente de tratamiento fonoaudiológico, patologías neurológicas, déficit intelectual, hipoacusia, síndromes u otras patologías diagnosticadas que podrían afectar la producción del habla. La adecuada función velofaríngea fue determinada en vivo a través de una evaluación perceptual de la resonancia. La nasalancia se determinó utilizando un Nasometer modelo 6450, durante la lectura de tres muestras de habla estandarizadas en español: un párrafo nasal (PN), un párrafo oronasal (PON) y un párrafo oral (PO). Además, se calculó la distancia de nasalancia. La comparación entre ambos sexos fue realizada con el test de Wilcoxon para muestras independientes. Resultados El PN presentó el mayor porcentaje de nasalancia con 52.13% (± 4.73), seguido del PON con 25.38% (± 3.7), y finalmente el PO, que presentó el valor más bajo de 14.15% (± 5.03). En tanto, la distancia de nasalancia fue del 37.98% (± 5.32). Por último, no se observaron diferencias significativas al comparar entre ambos sexos (p> 0.05). Conclusión Los valores de nasalancia obtenidos fueron similares a los observados para otros hispanohablantes. Además, hombres y mujeres mostraron puntuaciones similares. Los resultados de este estudio son una contribución a la evaluación indirecta de la función velofaríngea en adultos chilenos.

Role of Speech Aid Prosthesis as Diagnostic and Therapeutic Aid for Velopharyngeal Insufficiency Defect: A Case Report

ABSTRACT@#Soft palate tumors pose the challenge during reconstructive and rehabilitating procedures. Surgical resection of these tumors leads to velopharyngeal insufficiency (VPI). The primary effects of VPI are hypernasality and air-flow escape, while the secondary effects are abnormalities in speech articulation. Surgical revision along with speech therapy is a common approach to the treatment of VPI. Prosthetic management by means of speech aid prosthesis helps to reduce resonance, nasal emission and consonants errors. This clinical report describes the different stages of rehabilitation of velopharyngeal insufficiency defect following resection of malignant melanoma of left posterior alveolar ridge and soft palate. The speech aid prosthesis helped to rehabilitate the velopharyngeal insufficiency defect and aided in the diagnosis of extent of speech function improvement by perceptual and objective methods.

Investigation of postoperative hypernasality after superiorly based posterior pharyngeal flap / 대한악안면성형재건외과학회지

BACKGROUND: Velopharyngeal insufficiency that accompanies speech resonance and articulation disorders can be managed through several intervention methods such as speech-language therapy, prosthetic aids, and surgery. However, for patients with severe hypernasality, surgical interventions are highly recommended. Among available surgical techniques, the posterior pharyngeal flap is most common. CASE PRESENTATION: Two adult males with high nasalance scores underwent superiorly based posterior pharyngeal flap surgery, followed by speech testing by an expert speech-language therapist. Nasalance scores and articulation accuracy were assessed up until 1 year after the surgery. Nasalance scores were measured five times using a nasometer, after which the average value was calculated. CONCLUSIONS: Consistent declines in hypernasality over time are not easy to explain since the pedicled pharyngeal flap narrowed over time, secondary to cicatrization. However, scar tethering of the soft palate in a posterior direction could reduce the velopharyngeal port size over time. Therefore, long-term follow-up with intensive speech therapy is suggested for patients with severe hypernasality.

The Validity of New Material for Nasalance Evaluation and the Characteristics of Nasalance Scores in Children / 听力学及言语疾病杂志

Objective To study the validity of a new material, to verify the influence of gender and age differences on normal school children, and give advice to establishing the norms of mean nasalance for normal school children.Methods The mean nasalance of 190 school children in Shanghai was obtained by reading the new, old material and the vowel /a/,/o/,/e/,/i/,/u/, and /ü/, the mean nasalance was analyzed for the standard deviations.The gender and age score differences were compared.Results The new material was more stable than the old.In the test of /i/ and/ü/and the nasal material, the girls'' MNS was higher than the boys''.In testing the vowels /a/,/o/,/e/,/i/,/u/, and /ü/and the new material, there were differences in different ages.Conclusion The validity of new material is more stable than the old.The MNS of the normal children in Shanghai show that it is higher for the girls than the boys, and also higher for the older children than for the younger.

The comparative study of resonance disorders for Vietnamese and Korean cleft palate speakers using nasometer / 대한악안면성형재건외과학회지

BACKGROUND: Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. METHODS: Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this experimentation. Instead of Korean control, the standard value of Korean version of the simplified nasometric assessment procedures (kSNAP) was used. RESULT: The results are as follows: (1) the highest nasalance score among the Vietnamese normal vowels is the low vowel /a/; however, that of Korean normal vowels is the high vowel /i/. (2) The average nasalance score of Korean cleft palate vowels is 18% higher than that of Vietnamese cleft palate vowels. There was a nasalance score of over 45% among the vowels /e/ and /i/ in Vietnamese cleft palate patients and /i/, /o/, and /u/ in Korean cleft palate patients. CONCLUSION: These different nasalance scores of the same vowels seem to cause an ethnic difference between Vietnamese and Korean cleft palate children.

The Onphonation Threshold Pressure and Nasalance in Normal Subjects / 听力学及言语疾病杂志

Objective To investigate the difference and the correlation of the vowel's phonation threshold pressure and nasalance in normal subjects .Methods The Aeroview (GLOTTAL Enterprises)with the materials /pa/,/pi/,/pu/ was used to obtain phonation threshold pressure values and The NasalviewTM (Tiger Electronics Inc .,Seattle ,Shanghai) with the materials /a/,/i/,/u/was used to obtain nasalance values .A total of 30 subjects (15 males ,15 females ,and aged 19~30) years old received the tests .The results of the vowel's phonation threshold pressure and nasalance gender score difference were compared .Results The PTP gender scores of /a/,/i/,/u/in maleswere4.53±0.70cm,5.21±0.80cm,5.87±1.45cm,andinfemaleswere4.09±0.30cm,4.47±0.30cm, and 4 .77 ± 0 .32 cm ,respectively .There were significant differences between males and females in PTP values (P 0 .05) .The na‐salance gender score differences showed that females were greater than males .There were significant differences in different vowels(P<0 .05) .This study found a weak correlation between PTP and nasalance .Conclusion The relationship between oral pressure and nasal flow cannot be accurately measured by measuring PTP ,and /pa/is a relatively suit‐able material for testing oral pressure .

The Effect of Uvulopalatopharyngoplasty on Voice in Patients with OSAHS / 听力学及言语疾病杂志

Objective To study the impact of changes in the pharynx on the vocal functions and resonance functions to evaluate the effects of UPPP on voice and in order to provide a reference for the selection of UPPP sur‐gery population .Methods The 30 male adult patients who underwent UPPP surgery were recorded pre-surgery ,1-week post-surgery and 3-month post-surgery speech .Then the multi-dimensional voice program (MDVP) , linear prediction coding (LPC) ,the Nasometer Ⅱ(model 6450) were used to evaluate the vocal functions ,the oral resonance functions and the nasal resonance function .Results F0 ,jitter ,shimmer ,and NHR were unchanged from the pre-surgery to the post-surgery condition .One week after the surgery ,F1 ,F2 of /a/,/i/and /u/were un‐changed (P>0 .05) .Three months after surgery ,F1 ,F2 of the vowel /a/and F1 of the vowel /u/were remained essentially unchanged (P>0 .05);while the frequency of F1 ,F2 of the vowel /a/and of F2 of the vowel /u/were significantly higher compared to pre-surgery values (P0 .05) .Three months after surgery ,the nasalance scores of the oral sentence and the oranasal sentence were unchanged (P>0 .05);while the nasalance scores of the nasal sentence were significantly higher compared to pre-surgery values (P<0 .05) .Conclu‐sion UPPP doses not affect the vocal function .But it might have a certain effect on resonance function ,demonstra‐ted by the change of several formant frequency and nasalance .UPPP in all professional voice users should be cau‐tious .Such patients who want to undergo UPPP must be informed of this potential modification of the voice after sursery .

The Validity of New Material for Nasalance Evaluation and Nasalance Gender Score Differences / 听力学及言语疾病杂志

Objective This study aimed to develop reading material for nasalance evaluation ,and find out na-salance scores associated with genders .Methods The NasalView ? (Tiger Electronics Inc .,Seattle ,USA) was used to obtain nasalance values in the new and old material .A total of 102 subjects (51 males ,51 females) who have lived in Beijing for 18 years or longer at the time of the experiment received the tests ,the results from two pieces of material and the mean nasalance gender score differences were compared .Results The mean nasalance scores of sen-tences were 56 .58% ± 3 .43% for'Nasal sentence',33 .86% ± 5 .24% for'Oral sentence',and 49 .49% ± 4 .13% for'Oro -nasal sentence'respectively in the new material .The mean nasalance scores of sentences were 54 .31% ± 4 .43% for'Nasal sentence',35 .64% ± 5 .90% for'Oral sentence',and 47 .12% ± 4 .96% for'Oro-nasal sentence're-spectively in the old material .There were significant differences between males and females through materials .The nasalance gender score differences showed that females were bigger than males (P<0 .01) .This study found a cor-relation between the new and old materials :'Nasal sentence'(r=0 .899 ,P< 0 .01) ,'Oral sentence'(r= 0 .850 ,P<0 .01) ,and'Oro -nasal sentence'(r=0 .851 ,P<0 .01) .The standard error difference showed that the new was smaller than the old (P<0 .01) .Conclusion The new material for nasalance evaluation has a better test validity ,and there is a high correlation between the old materials .The usage of the new material for nasalance evaluation will produce more accurate results with higher credibility .Normal female's nasalance scores were higher than males .

Nasalance scores of Malay (Kelantan dialect) in children with and without palatal cleft

This study was designed to obtain and compare the nasalance scores produced by normal Malay children and those with repaired palatal cleft. Data from 103 noncleft children and 27 children with repaired clefts were included. All children were of Malay origin with the Malay language (Kelantan dialect) as their first language. Two short and simple test stimuli were constructed in the Malay language; one resembled the Nasal Sentences and the other resembled the Zoo Passage (oral passage) used in nasometer testing. Nasalance scores were obtained with the Nasometer II model 6400 by Kay Elemetrics. Calibration of the nasometer and collection of data followed the recommended protocol outlined in the manual. Nasalance scores for the Oral Passage was significantly higher (p < 0.001) for the children with repaired palatal clefts when compared to scores for children without clefts. However, no differences in nasalance scores were detected between both groups for the Nasal Passage. The normative nasalance scores for Malay children with Kelantan dialect was established, which can be used as an objective reference in the management of Malay patients with resonance disorders.

Speech, Phonation, Resonance Evaluation and Intervention for Dysarthria / 中国康复理论与实践

@#Objective To explore the characteristics and rehabilitation of Chinese dysarthria. Methods 31 patients and 63 normal controls were measured with maximum phonation time (MPT), pitch, intensity and mean airflow rate (MAR), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum midexpiratory flow (MMF), peak expiratory flow rate (PEFR); Nasalance was tested with Nasalance Acquisition System (NasalView); Speech intelligibility was tested with mandarin words card. And alternative movement rate (AMR) were also tested. All the patients were rehabilitated with physiologic approach, 16 patients who finished the course were tested again after rehabilitation. Results MPT, MAR, aspiratory function, AMR of the patients was remarkable lower than those of the control; the nasalance scores of vowel and nonnasal sounds, words, and sentence were remarkable higher than those of the control; the speech intelligibility was also lower. After intervention, MPT, aspiratory function, AMR, and speech intelligibility improved. In the index, only MPT and AMR were correlated with the speech intelligibility. The nasalance of /i/ and nonnasal sentence related with the listener perceptions of hypernasality. Conclusion The aspiratory and phonation function of the patients with dysarthria are impaired. The patients show hypernasality which is a type of resonance abnormity. AMR is declined. Speech intelligibility is much lower. Physiologic approach can improve their phonation, aspiration, articulation and communication ability, but can't for resonance. The longer the MPT, the more /pa、ta、ka/ in specific time, the higher the speech intelligibility. Nasalance could be used for evaluating the hypernasality.

Objective Evaluation of Surgically Corrected Velopharyngeal Insufficiency with Nasalance on Nasometer

BACKGROUND AND OBJECTIVES: Various kinds of surgical correction have been performed for management of velopharyngeal insufficiency (VPI). This study was conducted to evaluate the efficacy of nasometer by comparing the speech evaluation with the nasalance change in patients who had undergone surgical correction of VPI. MATERIALS AND METHODS: Twelve cases of VPI, who had undergone surgical correction at Seoul National University Hospital between January 1996 and June 1999, were retrieved in this study. Nasality in all cases was evaluated by the speech evaluation and nasometer before and 3 months after the operation. RESULTS: Postoperative nasalance decreased from 49.0% to 40.9%. Seven of nine patients with decreased nasalance after the operation showed improved nasality by the speech evaluation. Three patients with increased nasalance or no change in nasalance did not show change of nasality by the speech evaluation. Seven cases of improved nasality by the speech evaluation represented significant decrease in nasalance. CONCLUSION: The speech outcome after surgical correction of VPI may be evaluated objectively with the change of nasalance.

Effects of Endoscopic Sinus Surgery on Nasality / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: When the impairment of nasal airway patency in patients with chronic sinusitis such as mucosal edema or nasal polyps is resolved after functional endoscopic sinus surgery (FESS), it is expected that patients no longer complain of hyponasal voice. However, patients who have undergone FESS sometimes complain of more hyponasal voice, or thick voice. The purpose of this study was to examine the effect of FESS on voice in terms of nasality. MATERIALS AND METHODS: Thirty-three patients who underwent FESS and thirty normal adults who had no sinus or nasal pathology were selected for this study. We performed nasalance test for patients group before and 3 months after the operation and for the control group without any medication. RESULTS: Patients' preoperative mean nasalance were not low compared with that of control group in all sentences. It was different from perceptual hyponasality they had complained. Postoperative mean nasalance in patients showed statistically significant increase. Higher change ratio of nasalance was noted in Mamma passage than the other passages. CONCLUSION: There was significant increase in nasalance scores after FESS. Thus, we must consider the possibility of voice changes postoperatively in professional voice users.