Speech Evaluation for Apraxia of Speech with Chinese / 中国康复理论与实践

Objective To explore the evaluation for apraxia of speech (AOS) with Chinese. Methods 20 Chinese cases with AOS were assessed with Chinese material referred from Motor Speech Evaluation (MSE) using. Results The subtest of multiple repetitions of multisyl-labic words was the most difficult and single repetitions of monosyllabic words was the easiest for AOS patients (P<0.05). The score of the short sentences negatively correlated with both the scores of repetition ability (r=-0.865) and the fluency of speech (r=-0.614) (P<0.001). Conclusion Chinese material referred from MSE can be used for evaluation of AOS with Chinese.

Treatment of Velopharyngeal Insufficiency in Kabuki Syndrome: Case Report

PURPOSE: Kabuki syndrome is a multiple malformation syndrome that was first reported in Japan. It is characterized by distinctive Kabuki-like facial features, skeletal anomalies, dermatoglyphic abnormalities, short stature, and mental retardation. We report two cases of Kabuki syndrome with the surgical intervention and speech evaluation. METHODS: Both patients had velopharyngeal insufficiency and had a superior based pharyngeal flap operation. The preoperative and postoperative speech evaluations were performed by a speech language pathologist. RESULTS: In case 1, hypernasality was reduced in spontaneous speech, and the nasalance scores in syllable repetitions were reduced to be within normal ranges. In case 2, hypernasality in spontaneous speech was reduced from severe level to moderate level and the nasalance scores in syllable repetitions were also reduced to be within normal ranges. CONCLUSION: The goal of this article is to raise awareness among plastic surgeons who may encounter such patients with unique facial features. This study shows that pharyngeal flap operation can successfully correct the velopharyngeal insufficiency in Kabuki syndrome and post operative speech therapy plays a role in reinforcing surgical result.

Speech Outcome and Timing of Furlow Palatoplasty in Cleft Palate

Palatoplasty using Furlow's double-opposing Z-plasty has been performed from June, 1995 to September, 1999 at Seoul National University Children's Hospital. The goal of this study is to determine the optimal timing of repair and cleft severity affecting velopharyngeal function. This is the retrospective study of patients operated by the second author. The mean age of patients was 10.53 months. The patients could be divided into three groups-isolated cleft palate(n=70), unilateral cleft lip and palate(n=88), and bilateral cleft lip and palate(n=42). To evaluate the velopharyngeal function, we used two parameters, speech evaluation and cineofluorography using DSR(digital subtraction radiography). Also, to determine the relevance between cleft severity and speech development, we measured the distance between maxillary tuberosities and cleft margins. Among 200 patients, about 96% had no or minimal hypernasality and 87% had no or mild nasal emission. The cleft width and length of soft palate seemed not to be related with the speech development. Palatoplasty at the age under 12 months resulted in less 'nasal emission' and better 'articulation' of the parameters that were assessed at the age of 7 years. It can be concluded Furlow palatoplasty shows satisfactory results and also it seems that it is better to perform the operation before the age of 12 months.

Otolaryngological Manifestation of Hunter Syndrome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVE: Hunter syndrome(mucopolysaccharidosis (MPS) type II) is a genetic, metabolic disease of excessive mucopolysaccharide storage leading to mental and skeletal abnormalities, distinctive facial features, hearing loss, and airway problems. Its eventual lethal outcome results from cardiac failure and progressive obstruction of the airway. We tried to outline the otolaryngologic manifestations and management of patients based on the results of our study and review of the relevant literature. MATERIALS AND METHODS: Nine patients with Hunter syndrome were included in this study. Every patient was interviewed for the evaluation of any abnormality in the head and neck region, intelligence and language. Audio tests, temporal bone CT, and plain films of cervical spine were also performed. RESULTS: Upper airway obstruction occurred in most of patients, and necessitated tonsillectomy and adenoidectomy in 4 patients. Tracheal narrowing occurred in 3 patients. Otitis media with effusion, hearing loss and thickening of the external auditory canal and tympanic membrane were commonly observed in patients, and ventilation tubes were inserted in 4 patients. Mental retardation was more profound in the severe type Hunter syndrome, but speech function was disordered in both severe and mild type. CONCLUSION: Accurate evaluation and management of airway obstruction is needed to prevent lethal airway problems. Aggressive audio and otological managements, including the management of otitis media, hearing aids and speech therapy are required to enhance communicative development and improve their quality of life.