The Estimation of Resonance in Individuals with Repaired Cleft Palate by Using Temple Street Scale

The objective was to estimate resonance in individuals with repaired cleft-palate by using Temple-Street-Scale by cross-sectional sampling study. Data was collected from Clapp General Hospital, Lahore. This study was conducted by modifying Temple-Street-Scale after consent focusing on nasality, nasal emission. Total of 60 individuals with repaired cleft-palate, age ranging from 8-15 years with evidence of resonance disorders was recruited in the study. Results showed that the percentage of ages of an individual with repaired cleft palate was the high rate at 12 years (22%) which was high in males. The percentage of hyper-nasality (90%) at mild-moderate (26.7) level was higher than other resonance problems with consistency of 67%. The frequency of nasal emission was 83% with the consistency of 63%. The frequency was notable among individuals with repaired cleft-palate, having different levels, consistency, and frequency. So it was concluded that individuals with cleft-palate must follow proper speech-therapy sessions after repairing cleft for their better prognosis.

The acoustic parameters of perceptually normal voice production in Filipinos: An exploratory study among selected adults in Metro Manila

BACKGROUND AND OBJECTIVES: Acoustic analysis is an objective instrumental method that makes more accurate and reliable assessments of vocal characteristics possible. The aim of the current study was to describe the vocal characteristics of Filipinos with perceptually normal voices in terms of (1) fundamental frequency, (2) intensity, (3) frequency and intensity perturbations, (4) speaking fundamental frequency range, and (5) nasalance.METHODOLOGY: A total of 142 healthy adults aged 18 - 53 years participated in this study. The group was composed of 73 men (26.9 ± 6.4 years old) and 69 women (26.1 ± 6.5 years old). Voice samples were collected using Computerized Speech Laboratory™ (CSL; Model 4300B) during sustained phonation of vowel /a/ and spontaneous speech. Nasometer™ (Model 6200-3) was used to assess nasality while participants read plosive- and sibilant-loaded sentences.RESULTS AND CONCLUSION: The average acoustic values for males were F0 = 125.8 ± 23.4 Hz, SF0 = 122.6 ± 15.6 Hz, SF0 range = 85.8-269 Hz, SPL (speech) = 58.6 ± 5.3 dB, SPL (vowel) = 66.6 ± 6.2 dB, jitter = 0.92 ± 0.48%, shimmer = 2.21 ± 0.73%, nasalance = 12.5-17.1%; for females, F0 = 196.3 ± 23.0 Hz, SF0 = 194.8 ± 19.0 Hz, SF0 range = 97.1- 309.6Hz, SPL (speech) = 57.6 ± 4.3 dB, SPL (vowel) = 65.3 ± 4.5 dB, jitter = 1.12 ± 0.34%, shimmer = 2.7 ± 0.64%, nasalance = 13.1-19.1%. Significant differences were found between male and female subjects for F0, SF0, perturbation measures, and SPL during sustained phonation (p

Impacts of Tone on Auditory Perceptual Result of Hypernasality / 中国康复理论与实践

@#Objective To investigate how the tones impact the perceptual result of hypernasality for designing subjective evaluation material for hypernasality. Methods 20 normal children and 20 children with cleft palate were asked to read the material with different tones.The degree of hypernasality and nasality was recorded. Results There was no significant difference in the degree of perceived hypernasality and nasality rate among all the children in all the tones (P>0.05). Conclusion The impact of tones on perceived hypernasality can be ignored when designing the subjective evaluation material for hypernasality.

Impacts of Tone on Auditory Perceptual Result of Hypernasality / 中国康复理论与实践

Objective To investigate how the tones impact the perceptual result of hypernasality for designing subjective evaluation ma-terial for hypernasality. Methods 20 normal children and 20 children with cleft palate were asked to read the material with different tones. The degree of hypernasality and nasality was recorded. Results There was no significant difference in the degree of perceived hypernasality and nasality rate among all the children in all the tones (P>0.05). Conclusion The impact of tones on perceived hypernasality can be ignored when designing the subjective evaluation material for hypernasality.

Characteristics of Nasal Resonance and Perceptual Rating in Prelingual Hearing Impaired Adults

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.

Postoperative Assessment of Articulation and Velopharyngeal Functions in Oropharyngeal Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Velopharyngeal insufficiency from wide resection of soft palate and pharyngeal wall cause swallowing and articulation difficulty. Recently, reconstruction options have been significantly expanded and revitalized by the advent of free tissue transfer. The purpose of the present study was to report retrospectively collective articulation function scores and velopharyngeal function in patients who had reconstruction of radial forearm free flaps after primary resection for oropharyngeal cancer. SUBJECTS AND METHOD: Ten patients treated for oropharyngeal cancer by wide excision of primary lesion and reconstruction with radial forearm free flap were included. Assessment of speech intelligibility, diadochokinetic test, articulation discrimination test, nasometer, and velopharyngeal orifice examination with fiberoptic nasopharyngoscope was accomplished. Ten patients were classified into 4 groups according to the extent of surgical defect and portion of resection as follows. Group I: only one side of the lateral pharyngeal wall and palatine tonsil area (n=2), Group II: One side of palatine tonsil and soft palate (n=3), Group III: One side of palatine tonsil, soft palate, and part of the posterior pharyngeal wall (n=2), Group IV: One side of palatine tonsil, soft palate which reached beyond the uvula to opposite side, and part of the posterior pharyngeal wall (n=3). RESULTS: In the speech intelligibility and articulation discrimination test, five cases which belonged to the group I and II were evaluated to show excellent state. Five cases which belonged to group III and IV were judged to show moderate state. These results resulted from hypernasality of patients in group III and IV. In the articulation discrimination test, the results was increasingly affected with hypernasality from group I to group IV. In the nasometer test, patients of group III and IV were judged to show higher nasalance scoress (nasality) than those of group I and II. In the velopharyngeal orifice examination with fiberoptic nasopharyngoscope, near perfect closure or complete closure was achieved in an effort to bring about velopharyngeal closure in group I and II. But a small space was evident in the side reconstructed with a free flap in group III. In group IV, velopharyngeal space was not closed. CONCLUSION: We believe that this study aids in counseling patients and predicting their postoperative status of speech and velopharyngeal function according to the size of primary defect and the design of reconstruction. But, a prospective, randomized study will be needed for better evaluation.

The Relationship between Nasalance Score and Benign Vocal Fold Lesions / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Voice therapy using nasal stimulus sounds seems to facilitate a more easily produced, often better-sounding voice in benign vocal fold lesions. This study was designed (1) to determine whether nasalance score was different in patients with or without vocal fold masses, (2) to test if nasalance score was different from each disease group, and (3) to determine the difference between the normal and the disease group according to the reading materials. SUBJECTS AND METHOD: One hundred and sixty-eight subjects were evaluated. Each subject received a complete otolaryngological evaluation including physical examination, videostrobolaryngoscopy, objective voice measures, and evaluation by a speech-language pathologist. The control group consisted of 48 subjects with no nasal and vocal fold pathology. Subjects were evaluated on a nasometric assessment with three passages of oral-nasal sound. RESULTS: All disease groups demonstrated lower nasalance scores than the control group. CONCLUSION: There are significant differences in the nasalance scores between each disease group and the control group. Differences were also found according to the reading materials.

Applicability of the Thai nasality test.

The aim of this study was to investigate the applicability of a speech stimuli, the Thai Nasality Test, to identify the presence of hypernasality and hyponasality speech. The Thai Nasality Test was evaluated by a comparison study between the perceptual assessment rated by the investigators and the acoustic assessment by using a Nasometer. The study was conducted to 69 normal speakers, 36 dysarthric speakers, and 32 clients with cleft palate. The perceptual assessment was preceded acoustic assessment. Each subject was asked to read or repeat the Thai Nasality Test. Results indicate the reliability and validity of the Thai Nasality Test by a) a positive correlation between perceptual assessment and the instrumental assessment, b) a significant correlation between age and the Tuk Tuk passage and significant correlations between gender and the Manee as well as the Sai Yok water fall passages of the normal group, and c) the discriminating power between disordered speech from normal speech. This study indicated the Thai Nasality Test as a perfect speech stimuli to elicit speech sample for acoustic assessment, particularly the TukTuk and the Sai Yok water fall passages in assessing for hypernasality problems. While an applicability of nasal sentences the Manee to detect the hyponasality could not be confirmed definitely because there was no significant difference among studied groups.

Analysis of Changes in Nasal Formant, Spectra and Resonant Volume in Rhinosinus after Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There have been some reports about acoustic analysis of nasality changes after endoscopic sinus surgery (ESS), but no studies on the relationship between acoustic and volumetric changes of rhinosinus. The aims of this study were to measure and follow the postoperative course of nasal formant and spectral changes of nasal consonants and vowels, to evaluate the relationship between these acoustic and volumetric changes of rhinosinus, and to estimate the effect of rhinosinus as a nasal tract on nasal resonance after operation. MATERIAL AND METHODS: The changes of formants and spectral pattern were evaluated in 30 patients before ESS, and one, three and 12 months after ESS. Axial CT planes of 10 patients taken before and one month after the surgery were used for measuring the resonant volume of rhinosinus. RESULTS: The first formant was decreased when ESS was carried out one month after the surgery. However, it almost recovered to the preoperative level within 3 postoperative months. Twelve months after the surgery, the first formant did not show statistically significant differences compared to those of the preoperative state and the postoperative 1 month. The increment of resonant volume in rhinosinus was not correlated with the degree of decrement of the first formant one month after the surgery. CONCLUSION: Having a proper nasal cavity and the sinuses are important for nasality since hypernasality observed in the postoperative 1 month is thought to be caused by significantly increased resonant volume of the nasal tract. Compensatory control of velopharyngeal port as well as the resonant volume of the nasal tract are important factors to changes in nasality.

The assessment of the nasality of cleft palate speech with the linguistic approach.

Nasality, an abnormal voice quality, is generally considered the major deviation in cleft palate speech. The assessment of this problem is necessary for the appropriate management. The study aimed to design the standard speech test to measure nasality : hypernasality, hyponasality (cul-de-sac) and nasal emission. The test was directed to the production of the phonetic criterion for selecting words that evidence the problem. The hypernasality and hyponasality are judged in three levels : sound, word, and connected speech. But the nasal emission is separately judged from nasality in only two levels : sound and word. The speech test was also analyzed by nasometer to check whether it could measure nasality of cleft palate speech and the result agreed well with purpose of the test. This suggests that test can be clinically used as a standard pattern to identify nasality.

The Effect of Tonsillectomy and Adenoidectomy on Nasality / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The changes in voice that occur after tonsillectomy and adenoidectomy are mainly the nasal sound which can be measured with nasometer. This study was designed to estimate the postoperative changes in the voice, especially the nasal sound. MATERIALS AND METHODS: The subjects of this study included 26 patients who had received tonsillectomy and adenoidectomy. Thirty normal children were also selected as the control group. The nasalance and the each formants of /a/, /i/ of preoperative state were compared with those of postoperative 4 and 8 weeks. RESULTS: The preoperative nasality of the tonsillectomy and adenoidectomy group was significantly lower than that of the control group. Comparing the preoperative and postoperative 1 month state, there was significant increase in the nasalance, whereas it was recovered in the postoperative 2 months to the same level of the preoperatve state. The changes of the formants were not significantly noticed. CONCLUSION: Although the temporary increase in the nasalance does occur immediately after adenoidectomy, the postoperative 2 months state show no significant changes compared to the preoperative state. Therefore, the voice changes that come postoperatively could be considered as no concern for the non-professional voice user.