ABSTRACT
An evaluation was made of the impact of orthognathic surgery (OS) on speech, addressing in particular the effects of skeletal and airway changes on voice resonance characteristics and articulatory function. A prospective study was carried out involving 29 consecutive patientssubjected to OS. Preoperative, and short and long-term postoperative evaluations were made of anatomical changes (skeletal and airway measurements), speech evolution (assessed objectively by acoustic analysis: fundamental frequency, local jitter, local shimmer of each vowel, and formants F1 and F2 of vowel /a/), and articulatory function (use of compensatory musculature, point of articulation, and speech intelligibility). These were also assessed subjectively by means of a visual analogue scale. Articulatory function after OS showed immediate improvement and had further progressed at one year of follow up. This improvement significantly correlated with the anatomical changes, and was also notably perceived by the patient. On the other hand, although a slight modification in vocal resonance was reported and seen to correlate with anatomical changes of the tongue, hyoid bone, and airway, it was not subjectively perceived by the patients. In conclusion, the results demonstrated that OS had beneficial effects on articulatory function and imperceptible subjective changes in a patient's voice. Patients subjected to OS, apart from benefitting from improved articulatory function, should not be afraid that they will not recognise their voice after treatment.
Subject(s)
Orthognathic Surgery , Humans , Prospective Studies , Facial Bones , Speech , Tongue , Speech AcousticsABSTRACT
Measurement of hepatitis C virus (HCV) RNA may be beneficial in managing the treatment of patients with chronic HCV infection. In a phase 3 study comparing consensus interferon (IFN) and IFN-alpha2b treatment in patients with chronic HCV infection, serum samples were assayed for HCV RNA using two different assays: a quantitative multicycle reverse transcription-polymerase chain reaction (RT-PCR) method and the Quantiplex branched-chain DNA (bDNA) method. Lower and upper detection limits were 100 copies ml-1 and 5 x 10(6) copies ml-1, respectively, for the RT-PCR method, and 3.5 x 10(5) and 4 x 10(7) genome equivalents ml-1, respectively, for the bDNA method. The two assays were generally concordant over the common range of detectability. The major discrepancy was where PCR still indicated detectable virus in the sample but the bDNA result was negative. Assessment of serum samples during IFN treatment demonstrated that 37% of samples were negative for HCV RNA by bDNA but positive by RT-PCR. Differences were also noted in the quantification of baseline HCV RNA by genotype. These data suggest that HCV patients could be categorized as treatment responders by the bDNA assay when the more sensitive RT-PCR assay indicates lack of complete viral response.
