Vathulya Madhubari, Sarkar Subrato, Singh Indra Vir, Prajapati Tripta, Sharma Pankaj
Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Rensselear Polytechnic Institute, Troy, New York, United States.
Indian J Plast Surg. 2024 Jul 18;57(Suppl 1):S24-S29. doi: 10.1055/s-0044-1788591. eCollection 2024 Dec.
Speech, one of the main functions affected by cleft palate, involves a complex orchestra of sound deformation by various organs including the larynx, pharynx, epiglottis, palate, tongue, lip, and other structures complementing them. Although the effects of palatoplasty are traditionally evaluated subjectively, objective parameters have seldom been described to compare the pre- and postrepair functions. The study tries to extract the palatal and pharyngeal muscles while uttering various Hindi syllables and tries to find the percentage contraction of these structures as an objective assessment. Digital Imaging and Communications in Medicine (DICOM) images while uttering each syllable of the Hindi syllable are obtained by subjecting a healthy volunteer to a dynamic magnetic resonance imaging (MRI). Using freeform geomagic software, 3D models of the structure of the pharynx and palate were created, which were then used to create a finite element model. Different anatomical constraints were applied to the muscles obtained. The finite element model was tested for convergence and a suitably fine mesh was used to obtain the results. The percentage of contraction of the palate and pharynx for uttering different syllables was thus evaluated. The palate and the posterior pharyngeal walls yielded different contractions for different syllables independent of each other. The highest contraction for the palate and posterior pharyngeal wall was for the syllable /k/ and the lowest regarding the palate was for /h/ and /eː/ for the pharyngeal wall. Using computational modeling, quantification of speech in terms of percentage contraction of the palate and pharynx has been attempted for the Hindi language. Once validated with a larger population, the database may be used to quantify speech deformities due to structural pathologies in terms of palatal and pharyngeal contractions and help us assess the effectiveness of corrective surgeries for them.
腭裂影响的主要功能之一是言语，它涉及由包括喉、咽、会厌、腭、舌、唇以及其他辅助结构在内的各种器官进行的复杂的声音变形。尽管传统上腭裂修复术的效果是通过主观评估的，但很少有客观参数被描述用于比较修复前后的功能。该研究试图在发出各种印地语音节时提取腭部和咽部肌肉，并试图找出这些结构的收缩百分比作为一种客观评估方法。
通过让一名健康志愿者接受动态磁共振成像（MRI），在发出印地语音节的每个音节时获取医学数字成像和通信（DICOM）图像。使用自由形式的Geomagic软件创建了咽部和腭部结构的三维模型，然后用这些模型创建了有限元模型。对获得的肌肉施加了不同的解剖学约束。对有限元模型进行了收敛性测试，并使用了适当精细的网格来获取结果。由此评估了发出不同音节时腭部和咽部的收缩百分比。
腭部和咽后壁对于不同音节产生了相互独立的不同收缩。腭部和咽后壁收缩程度最高的音节是/k/，腭部收缩程度最低的是/h/，咽后壁收缩程度最低的是/eː/。
通过计算建模，已尝试针对印地语，根据腭部和咽部的收缩百分比对言语进行量化。一旦在更大规模的人群中得到验证，该数据库可用于根据腭部和咽部的收缩情况量化由于结构病变导致的言语畸形，并帮助我们评估针对这些畸形的矫正手术的有效性。
