Kummer Ann W, Marshall Jennifer L, Wilson Margaret M
Division of Speech-Language Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Division of Speech-Language Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Int J Pediatr Otorhinolaryngol. 2015 Mar;79(3):286-95. doi: 10.1016/j.ijporl.2014.12.036. Epub 2015 Jan 5.
Although a history of cleft palate is the most common cause of velopharyngeal dysfunction (VPD), there are other disorders that can also cause hypernasality and/or nasal emission. These include other structural anomalies of the velopharyngeal valve (velopharyngeal insufficiency), neurophysiological disorders that result in inadequate velopharyngeal movement (velopharyngeal incompetence), and even faulty articulation placement in the pharynx (velopharyngeal mislearning). Unfortunately, individuals with non-cleft causes of hypernasality and/or nasal emission do not typically present at a cleft palate/craniofacial center where there are professionals who specialize in the evaluation and treatment of these disorders. As a result, they are often misdiagnosed and do not receive appropriate treatment. In this review, we present various conditions that can cause hypernasality and/or nasal emission during speech. We discuss appropriate treatment based on the underlying cause of the condition. It is important that pediatric otolaryngologists are able to recognize these disorders so that affected patients are referred to specialists in velopharyngeal dysfunction for treatment.
尽管腭裂病史是腭咽功能障碍（VPD）最常见的原因，但还有其他疾病也可导致鼻音过重和/或鼻漏气。这些疾病包括腭咽瓣的其他结构异常（腭咽闭合不全）、导致腭咽运动不足的神经生理疾病（腭咽功能不全），甚至是咽部错误的发音位置（腭咽学习错误）。不幸的是，因非腭裂原因导致鼻音过重和/或鼻漏气的个体通常不会前往腭裂/颅面中心就诊，而这些中心有专门评估和治疗这些疾病的专业人员。因此，他们常常被误诊，无法得到恰当的治疗。在本综述中，我们介绍了各种可导致言语时鼻音过重和/或鼻漏气的疾病情况。我们根据病情的潜在病因讨论了适当的治疗方法。小儿耳鼻喉科医生能够识别这些疾病非常重要，这样受影响的患者就能被转诊至腭咽功能障碍方面的专家处接受治疗。
