Heng Yin, Chunli Guo, Bing Shi, Yang Li, Jingtao Li
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2017 Jun 1;35(3):296-300. doi: 10.7518/hxkq.2017.03.013.
To characterize the velopharyngeal closure patterns and speech performance among submucous cleft palate patients.
Patients with submucous cleft palate visiting the Department of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University between 2008 and 2016 were reviewed. Outcomes of subjective speech evaluation including velopharyngeal function, consonant articulation, and objective nasopharyngeal endoscopy including the mobility of soft palate, pharyngeal walls were retrospectively analyzed.
A total of 353 cases were retrieved in this study, among which 138 (39.09%) demonstrated velopharyngeal competence, 176 (49.86%) velopharyngeal incompetence, and 39 (11.05%) marginal velopharyngeal incompetence. A total of 268 cases were subjected to nasopharyngeal endoscopy examination, where 167 (62.31%) demonstrated circular closure pattern, 89 (33.21%) coronal pattern, and 12 (4.48%) sagittal pattern. Passavant's ridge existed in 45.51% (76/167) patients with circular closure and 13.48% (12/89) patients with coronal closure. Among the 353 patients included in this study, 137 (38.81%) presented normal articulation, 124 (35.13%) consonant elimination, 51 (14.45%) compensatory articulation, 36 (10.20%) consonant weakening, 25 (7.08%) consonant replacement, and 36 (10.20%) multiple articulation errors.
Circular closure was the most prevalent velopharyngeal closure pattern among patients with submucous cleft palate, and high-pressure consonant deletion was the most common articulation abnormality. Articulation error occurred more frequently among patients with a low velopharyngeal closure rate.
描述黏膜下腭裂患者的腭咽闭合模式及语音表现。
回顾2008年至2016年间在四川大学华西口腔医院唇腭裂外科就诊的黏膜下腭裂患者。对主观语音评估结果（包括腭咽功能、辅音清晰度）以及客观鼻咽内镜检查结果（包括软腭活动度、咽壁情况）进行回顾性分析。
本研究共纳入353例患者，其中138例（39.09%）腭咽功能正常，176例（49.86%）腭咽功能不全，39例（11.05%）边缘性腭咽功能不全。共268例患者接受了鼻咽内镜检查，其中167例（62.31%）呈现环状闭合模式，89例（33.21%）呈现冠状闭合模式，12例（4.48%）呈现矢状闭合模式。在环状闭合的患者中，45.51%（76/167）存在咽后壁嵴；在冠状闭合的患者中，13.48%（12/89）存在咽后壁嵴。在本研究纳入的353例患者中，137例（38.81%）发音正常，124例（35.13%）辅音省略，51例（14.45%）代偿性发音，36例（10.20%）辅音弱化，25例（7.08%）辅音替代，36例（10.20%）存在多种发音错误。
环状闭合是黏膜下腭裂患者中最常见的腭咽闭合模式，高频辅音省略是最常见的发音异常。腭咽闭合率低的患者发音错误更频繁。
