Kummer Ann W, Clark Stacey L, Redle Erin E, Thomsen Leisa L, Billmire David A
Division of Speech Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
Cleft Palate Craniofac J. 2012 Mar;49(2):146-52. doi: 10.1597/10-285. Epub 2011 Apr 18.
To determine methods by which professionals serving cleft palate/craniofacial teams are evaluating velopharyngeal function and to ascertain what they consider as a successful speech outcome of surgery.
A 12-question survey was developed for professionals involved in management of velopharyngeal dysfunction.
The survey was distributed through E-mail lists for the American Cleft Palate-Craniofacial Association and Division 5 of the American Speech-Language-Hearing Association. Only speech-language pathologists and surgeons were asked to complete the survey. A total of 126 questionnaires were completed online.
Standard speech evaluations include perceptual evaluation (99.2%), intraoral examination (96.8%), nasopharyngoscopy (59.3%), nasometry (28.9%), videofluoroscopy (19.2%), and aerodynamic measures (4.3%). Significant variation existed in the types and levels of perceptual rating scales. Pharyngeal flap (52.9%) is the most commonly performed procedure for velopharyngeal insufficiency, followed by sphincter pharyngoplasty (27.5%). Criteria for surgical success included normal speech (50.8%), acceptable speech (27.9%), and "improved" speech (8%). However, most respondents felt that success should be defined as normal speech (71.2%). Most respondents believed that surgical success should be determined by the team speech-language pathologist (81.5%); although, some felt success should be determined by the patient/family (17.7%).
This survey shows considerable variability in the methods for evaluating and reporting speech outcomes following surgery. There is inconsistency in what is considered a successful surgical outcome, making comparison studies impossible. Most respondents thought that success should be defined as normal speech, but this is not happening in current practice.
确定腭裂/颅面团队的专业人员评估腭咽功能的方法，并确定他们认为手术成功的语音结果是什么。
针对参与腭咽功能障碍管理的专业人员开展了一项包含12个问题的调查。
该调查通过美国腭裂-颅面协会和美国言语-语言-听力协会第5分部的电子邮件列表进行分发。仅邀请言语治疗师和外科医生完成该调查。共有126份问卷通过在线方式完成。
标准的语音评估包括感知评估（99.2%）、口腔检查（96.8%）、鼻咽镜检查（59.3%）、鼻音测量（28.9%）、电视荧光透视检查（19.2%）和气动力学测量（4.3%）。感知评定量表的类型和水平存在显著差异。咽瓣术（52.9%）是治疗腭咽闭合不全最常用的手术方法，其次是括约肌咽成形术（27.5%）。手术成功的标准包括正常语音（50.8%）、可接受的语音（27.9%）和“改善的”语音（8%）。然而，大多数受访者认为成功应定义为正常语音（71.2%）。大多数受访者认为手术成功应由团队中的言语治疗师确定（81.5%）；不过，一些人认为成功应由患者/家属确定（17.7%）。
本次调查显示，术后评估和报告语音结果的方法存在很大差异。对于什么被认为是成功的手术结果存在不一致，这使得比较研究无法进行。大多数受访者认为成功应定义为正常语音，但目前的实践中并非如此。
