Ma Li, Shi Bing, Li Yang, Zheng Qian
Department of Cleft Lip and Palate Surgery, West China Stomatological Hospital, State Key Laboratory of Oral Disease, West China College of Stomatology, Sichuan University, Chengdu, China.
J Craniofac Surg. 2013 Jul;24(4):1229-31. doi: 10.1097/SCS.0b013e31828a7877.
There is no doubt that perceptual speech assessment and instrumental examination could provide different diagnostic information on patients with cleft palate (CP), but not all patients simultaneously need the 2 examinations. So the purposes of this study were to explore a simple and effective evaluation method to assess velopharyngeal function and to investigate speech traits that affect the diagnosis of velopharyngeal function in patients with CP. The investigators implemented a retrospective study, and 247 postoperative patients with CP were selected, including 155 boys and 92 girls, with a mean (SD) age of 13 years and 2 months (7 years and 7 months). All of these patients were assessed by perceptual speech evaluation and nasopharyngoscopy after surgery, and the result was divided into velopharyngeal closure (VPC), velopharyngeal insufficiency, and marginal VPC. The number of diagnostic consistency patients was 170 (VPC, 51 patients; velopharyngeal insufficiency, 115 patients; marginal VPC, 4 patients), and the consistent ratio was 68.83%. There was no significant difference between perceptual speech assessment and nasopharyngoscopy. Furthermore, the difference in distribution of hypernasality between the consistent group and the inconsistent group was significant. In addition, the correlation analysis indicated that surgical age, hypernasality, nasal emission, and compensatory articulation were correlated with the velopharyngeal function (P < 0.05). In conclusion, perceptual speech assessment could make a correct diagnosis in the absence of instrumental examination. The severity of hypernasality might affect the diagnosis of the velopharyngeal function. Much more attention should be paid to the surgical age, the alteration of hypernasality, nasal emission, and compensatory articulation during CP therapy.
毫无疑问，感知语音评估和仪器检查可为腭裂患者提供不同的诊断信息，但并非所有患者都同时需要这两种检查。因此，本研究的目的是探索一种简单有效的评估方法来评估腭咽功能，并研究影响腭裂患者腭咽功能诊断的语音特征。研究人员进行了一项回顾性研究，选取了247例腭裂术后患者，其中包括155名男孩和92名女孩，平均（标准差）年龄为13岁2个月（7岁7个月）。所有这些患者术后均接受了感知语音评估和鼻咽喉镜检查，结果分为腭咽闭合（VPC）、腭咽功能不全和边缘性VPC。诊断一致的患者有170例（VPC，51例；腭咽功能不全，115例；边缘性VPC，4例），一致率为68.83%。感知语音评估和鼻咽喉镜检查之间无显著差异。此外，一致组和不一致组在鼻音过重分布上的差异具有统计学意义。此外，相关性分析表明，手术年龄、鼻音过重、鼻漏气和代偿性构音与腭咽功能相关（P < 0.05）。总之，在没有仪器检查的情况下，感知语音评估也可以做出正确诊断。鼻音过重的严重程度可能会影响腭咽功能的诊断。在腭裂治疗过程中，应更加关注手术年龄、鼻音过重的变化、鼻漏气和代偿性构音。
