Finkelstein Y, Nachmani A, Ophir D
Department of Otolaryngology-Head and Neck Surgery, Meir Hospital, Kfar Saba, Israel.
Arch Otolaryngol Head Neck Surg. 1994 Aug;120(8):846-51. doi: 10.1001/archotol.1994.01880320048011.
To present illustrative cases showing various tonsillar influences on speech and to present a clinical method for patient evaluation establishing concepts of management and a rational therapeutic approach.
The cases were selected from a group of approximately 1000 patients referred to the clinic because of suspected palatal diseases. Complete velopharyngeal assessment was made, including otolaryngologic, speech, and hearing examinations, polysomnography, nasendoscopy, multiview videofluoroscopy, and cephalometry.
New observations further elucidate the intimate relation between the tonsils and the velopharyngeal valve. The potential influence of the tonsils on the velopharyngeal valve mechanism, in hindering or assisting speech, is described.
In selected cases, the decision to perform tonsillectomy depends on its potential effect on speech. The combination of nasendoscopic and multiview videofluoroscopic studies of the mechanical properties of the tonsils during speech is required for patients who present with velopharyngeal insufficiency in whom tonsillar hypertrophy is found. These studies are also required in patients with palatal anomalies who are candidates for tonsillectomy.
展示说明扁桃体对言语产生各种影响的病例，并介绍一种用于患者评估的临床方法，确立管理理念和合理的治疗方法。
这些病例选自一组因疑似腭部疾病而转诊至诊所的约1000名患者。进行了全面的腭咽评估，包括耳鼻喉科、言语和听力检查、多导睡眠监测、鼻内镜检查、多视角电视透视检查和头影测量。
新的观察结果进一步阐明了扁桃体与腭咽瓣之间的密切关系。描述了扁桃体对腭咽瓣机制在阻碍或辅助言语方面的潜在影响。
在特定病例中，决定是否进行扁桃体切除术取决于其对言语的潜在影响。对于存在腭咽功能不全且发现扁桃体肥大的患者，需要结合鼻内镜检查和多视角电视透视检查来研究言语过程中扁桃体的机械性能。对于拟行扁桃体切除术的腭部异常患者，也需要进行这些检查。
