Phonological Characteristics and Rehabilitation of Abnormal Velar Consonants in Operated Patients with Cleft Palate / 听力学及言语疾病杂志

Objective To study the phonological characteristics and rehabilitation methods of abnormal velar consonants in operated patients with cleft palate.Methods A total of 110 patients (60 males and 50 females, aged 4 to 27 years with the mean age as 9.01±4.12) with abnormal velar consonants after cleft palate treatment over one month were involved in this study.According to the severity of articulation disorders, the patients were divided into mild, moderate and severe groups who received 1 to 5 weeks of targeted rehabilitation training.The phonological characteristics of abnormal velar consonants and the correction between velar consonant misarticulation and age/gender were analyzed.Results The error rate of /g/ was 96.36%(106/110) which was the highest, then /k/ and /h/ was 74.55%(82/110) and 19.09%(21/110), respectively.Both /g/(80.19%, 85/106) and /h/(76.19%, 16/21) mainly showed omission while /k/ was mainly substituted by /h/(54.88%, 45/82) and /t/(29.27%, 24/82).95 cases were cured and 12 cases improved after specific rehabilitation.The overall cure rate was 86.36%.The cure rates for the mild, moderate and severe groups were 96.00%(24/25), 90.91%(30/33), and 78.85%(41/52),respectively.Males accounted for 51.76%(44/85) and females for 48.24%(41/85) among omission cases;males accounted for 51.47%(35/68) and females for 48.53%(33/68) among substitution cases.There was no significant correction among the number of incorrect words and age(r=-0.140, P>0.05) as well as gender(r=0.090, P>0.1).Conclusion Abnormal velar consonants in operated patients with cleft palate mainly had problems with /g/ and /k/./g/ showed mainly omission errors and /k/ mainly substitution.The targeted rehabilitation methods established in the study are significantly beneficial.

Phonological characteristics and rehabilitation training of abnormal velar in children with functional articulation disorders / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To explore the phonological characteristics and rehabilitation training of abnormal velar in patients with functional articulation disorders (FAD).</p><p><b>METHODS</b>Eighty-seven patients with FAD were observed of the phonological characteristics of velar. Seventy-two patients with abnormal velar accepted speech training. The correlation and simple linear regression analysis were carried out on abnormal velar articulation and age.</p><p><b>RESULTS</b>The articulation disorder of /g/ mainly showed replacement by /d/, /b/ or omission. /k/ mainly showed replacement by /d/, /t/, /g/, /p/, /b/. /h/ mainly showed replacement by /g/, /f/, /p/, /b/ or omission. The common erroneous articulation forms of /g/, /k/, /h/ were fronting of tongue and replacement by bilabial consonants. When velar combined with vowels contained /a/ and /e/, the main error was fronting of tongue. When velar combined with vowels contained /u/, the errors trended to be replacement by bilabial consonants. After 3 to 10 times of speech training, the number of erroneous words decreased to (6.24±2.61) from (40.28±6.08) before the speech training was established, the difference was statistically significant (Z=-7.379, P=0.000). The number of erroneous words was negatively correlated with age (r=-0.691, P=0.000). The result of simple linear regression analysis showed that the determination coefficient was 0.472.</p><p><b>CONCLUSIONS</b>The articulation disorder of velar mainly shows replacement, varies with the vowels. The targeted rehabilitation training hereby established is significantly effective. Age plays an important role in the outcome of velar.</p>

Nasoendoscopy of velopharynx before and during diagnostic therapy

Nasoendoscopy is an important tool for assessing velopharyngeal function. The purpose of this study was to analyze velar and pharyngeal wall movement and velopharyngeal gap during nasoendoscopic evaluation of the velopharynx before and during diagnostic therapy. Nasoendoscopic recordings of 10 children with operated cleft lip and palate were analyzed according to the International Working Group Guidelines. Ratings of movement of velum and pharyngeal walls, and size, location and shape of gaps were analyzed by 3 speech-language pathologists (SLPs). Imaging was obtained during repetitions of the syllable /pa/ during a single nasoendoscopic evaluation: (a) before diagnostic therapy, and (b) after the children were instructed to impound and increase intraoral air pressure (diagnostic therapy). Once the patients impounded and directed air pressure orally, the displacement of the velum, right, left and posterior pharyngeal walls increased 40, 70, 80, and 10%, respectively. Statistical significance for displacement was found only for right and left lateral pharyngeal walls. Reduction in gap size was observed for 30% of the patients and other 40% of the gaps disappeared. Changes in gap size were found to be statistically significant between the two conditions. In nasoendoscopic assessment, the full potential of velopharyngeal displacement may not be completely elicited when the patient is asked only to repeat a speech stimulus. Optimization of information can be done with the use of diagnostic therapy’s strategies to manipulate VP function. Assuring the participation of the SLP to conduct diagnostic therapy is essential for management of velopharyngeal dysfunction.

A cephalometric study on the velopharyngeal changes after maxillary protraction / 대한치과교정학회지

The purpose of this study was to investigate cephalometrically the short term static velopharyngeal changes in 25 patients (10 boys and 15 girls, aged from 5 years 9 months to 12 years 10 months in the beginning of treatment) with skeletal Class III malocclusions who underwent nonsurgical maxillary protraction therapy with a facemask. The linear, angular and ratio measurements were made on lateral cephalograms. Only the change in hard palatal plane angle was negatively correlated with the change in maxillary depth or N-perp to A (p < 0.01). The change in velar angle showed a statistically significant increase (p < 0.001). This change was influenced more by the soft palatal plane angle than by the hard palatal plane angle (p < 0.001). The changes in soft tissue nasopharyngeal depth and hard tissue nasopharyngeal depth showed statistically significant increases (p < 0.001). Correlations between the changes in soft tissue (or hard tissue) nasopharyngeal depth and the change in soft palatal plane angle were significant (p < 0.05). The increase in hard palate length was statistically significant (p < 0.001). The change in hard palate length was negatively correlated with the change in soft tissue nasopharyngeal depth (p < 0.05). The change in need ratio S (C) showed a statistically significant increase (p < 0.001). But this difference was within the normal range reported by previous studies. These findings indicate that the velopharyngeal competence was maintained even if the anatomical condition of the static velopharyngeal area were changed after maxillary protraction.