Correlation of Vocal Intensity with Velopharyngeal Closing Mechanism in Individuals with and without Complaint of Velopharyngeal Dysfunction

Introduction Velopharyngeal sphincter is a portion of the muscle of the palatopharyngeal arch that is capable of separating the oral cavity from the nasal cavity. It has not been determined yet whether voice intensity has an influence on this capacity. Velopharyngeal sphincter closure is accomplished by elevating and retracting the soft palate at the same time as the nasopharyngeal walls are constricted. Objective This study aims to correlate voice intensity with velopharyngeal sphincter closure in individuals without velopharyngeal dysfunction and patients with cleft lip and palate. Methods We conducted a cross-sectional, comparative, and contemporary study. The sample consisted of 16 individuals in the control group and 16 individuals in the study group. Patients underwent instrumental assessment, which we subsequently analyzed using a computer program, and a brief medical history review. The mean age of the control group was 27.6 years, whereas the mean age of the case group was 15.6 years. Results Cases showed higher voice intensity in regular and weak fricative sentences when compared with controls. There was no agreement on the analysis of the instrumental assessment between the assessors and the computer program. Regardless of voice intensity, the computer program demonstrated a similar closure pattern. Conclusion The computer program showed similar closure pattern for the three levels of intensity. There was no agreement between the three assessors and the closure pattern determined by the computer program. There was no statistically significant correlation between voice intensity and degree of velopharyngeal sphincter closure.

Caracterização do posicionamento e ação motora de língua em pacientes com fissura labiopalatina em um serviço de referência de Porto Alegre / Characterization of the positioning and motor action of the tongue in patients with cleft lip and palate in a reference service in Porto Alegre

Introdução: As fissuras labiopalatinas apresentam-se como a anomalia congênita mais frequente na face, ocorrendo como transtornos isolados ou associados a outras anormalidades, podendo repercutir em alterações fonoaudiológicas ligadas à fala e motricidade orofacial. Este estudo objetivou caracterizar aspectos do exame orofacial correlacionando o tipo de fissura com o posicionamento de língua em repouso e na deglutição, bem como seu desempenho na realização de praxias orofaciais, em sujeitos com fissura labiopalatina acompanhados no Serviço de Cirurgia Plástica Craniomaxilofacial do Hospital de Clínicas de Porto Alegre (HCPA). Métodos: Trata-se de um estudo transversal, realizado por meio de pesquisa documental, realizada nos registros dos prontuários de casos de fissura labiopalatina, atendidos no HCPA.Dos 123 prontuários selecionados, foram estratificados dados de 34 pacientes, por apresentarem avaliação orofacial completa nos aspectos selecionados. Resultados: Prevaleceu a fissura labiopalatal unilateral (32,4%), havendo predomínio discreto do sexo masculino (55,9%) e faixa etária de 6 a 10 anos de idade (26,5%). A posição de língua no repouso manifestou-se alterada na maioria dos casos apresentados, bem como na função de deglutição. A limitação e assimetria de língua na realização das praxias orofaciais manifestaram-se igualmente na maioria dos casos. Conclusão: Não foi encontrada associação estatística significativa quando relacionada à classificação das fissuras com a postura de língua na deglutição, postura de língua nas praxias e respiração. Contudo, correlacionaram-se as fissuras labiais unilaterais e palatais apenas com a postura da língua em repouso na papila palatina, o mesmo apresentou relação estatisticamente significativa (p 0,008)

Introduction: Cleft lip and clef palate are the most common congenital anomalies of the face, occurring as isolated disorders or in association with other abnormalities, which may lead to speech-language disorders related to orofacial changes. This study aimed to characterize aspects of the orofacial examination by correlating cleft type with the positioning of the tongue at rest and during swallowing, as well as performance of orofacial movements, in subjects with cleft lip/palate cared for at the Department of Plastic Craniomaxilofacial Surgery of the Hospital de Clinicas of Porto Alegre (HCPA). Methods: This was a cross-sectional study based on an analysis of the medical records of cases of cleft lip/palate treated at the HCPA. Of the 123 records selected, we stratified data of 34 patients who had undergone complete orofacial evaluation in selected aspects. Results: Unilateral cleft lip and palate prevailed (32.4%), with a slight predominance of males (55.9%) and the 6-10-year age bracket (26.5%). In most of the cases, the resting position of the tongue as well as the swallowing function were found to be changed. Limitation and asymmetry of the tongue in performing orofacial movements were seen in most cases as well. Conclusion: There was no statistically significant association as related to the classification of the clefts with the positioning of the tongue in swallowing, tongue posture during movements, and breathing. However, unilateral cleft lip and palate correlated only with resting tongue posture in the palatine papilla, which was statistically significant (p 0.008)