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Velopharyngeal dysfunction

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https://www.readbyqxmd.com/read/28802381/diagnosing-subtle-palatal-anomalies-validation-of-video-analysis-and-assessment-protocol-for-diagnosing-occult-submucous-cleft-palate
#1
Ryan Rourke, Seth M Weinberg, Mary L Marazita, Noel Jabbour
INTRODUCTION: Submucous cleft palate (SMCP) classically involves bifid uvula, zona pellucida, and notched hard palate. However, patients may present with more subtle anatomic abnormalities. The ability to detect these abnormalities is important for surgeons managing velopharyngeal dysfunction (VPD) or considering adenoidectomy. OBJECTIVES: Validate an assessment protocol for diagnosis of occult submucous cleft palate (OSMCP) and identify physical examination features present in patients with OSMCP in the relaxed and activated palate positions...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28655049/video-game-rehabilitation-of-velopharyngeal-dysfunction-a-case-series
#2
Gabriel J Cler, Talia Mittelman, Maia N Braden, Geralyn Harvey Woodnorth, Cara E Stepp
Purpose: Video games provide a promising platform for rehabilitation of speech disorders. Although video games have been used to train speech perception in foreign language learners and have been proposed for aural rehabilitation, their use in speech therapy has been limited thus far. We present feasibility results from at-home use in a case series of children with velopharyngeal dysfunction (VPD) using an interactive video game that provided real-time biofeedback to facilitate appropriate nasalization...
June 22, 2017: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/28602633/automated-cleft-speech-evaluation-using-speech-recognition
#3
Megan Vucovich, Rami R Hallac, Alex A Kane, Julie Cook, Cortney Van'T Slot, James R Seaward
Perceptual evaluation remains the gold-standard evaluation of cleft speech, but with any human interpretation, there can be bias. Eliminating bias, allowing comparison of speech data between units, is labor and time intensive. Globally, there is a shortage of listeners. We have developed a computer learning system to evaluate cleft speech. Our automated cleft speech evaluator interprets resonance and articulatory cleft speech errors. Speech recognition engines typically ignore voice characteristics and speech errors of the speaker, but in cleft speech evaluation, these features are paramount...
May 17, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28538580/what-s-new-in-cleft-palate-and-velopharyngeal-dysfunction-management
#4
Sanjay Naran, Matthew Ford, Joseph E Losee
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Have a clear understanding of the evolution of concepts of velopharyngeal dysfunction, especially as it relates to patients with a cleft palate. 2. Explain the subjective and objective evaluation of speech in children with velopharyngeal dysfunction. 3. On the basis of these diagnostic findings, be able to classify types of velopharyngeal dysfunction. 4. Develop a safe, evidence-based, patient-customized treatment plan for velopharyngeal dysfunction founded on objective considerations...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28362219/validity-of-auditory-perceptual-assessment-of-velopharyngeal-function-and-dysfunction-the-vpc-sum-and-the-vpc-rate
#5
Anette Lohmander, Emilie Hagberg, Christina Persson, Elisabeth Willadsen, Inger Lundeborg, Julie Davies, Christina Havstam, Maria Boers, Mia Kisling-Møller, Suvi Alaluusua, Ragnhild Aukner, Nina Helen Pedersen, Leena Turunen, Jill Nyberg
Overall weighted or composite variables for perceptual auditory estimation of velopharyngeal closure or competence have been used in several studies for evaluation of velopharyngeal function during speech. The aim of the present study was to investigate the validity of a composite score (VPC-Sum) and of auditory perceptual ratings of velopharyngeal competence (VPC-Rate). Available VPC-Sum scores and judgments of associated variables (hypernasality, audible nasal air leakage, weak pressure consonants, and non-oral articulation) from 391 5-year olds with repaired cleft palate (the Scandcleft project) were used to investigate content validity, and 339 of these were compared with an overall judgment of velopharyngeal competence (VPC-Rate) on the same patients by the same listeners...
March 31, 2017: Clinical Linguistics & Phonetics
https://www.readbyqxmd.com/read/28321987/cephalometric-findings-among-children-with-velopharyngeal-dysfunction-following-adenoidectomy-a-retrospective-study
#6
F Kassem, Y Ebner, B Nageris, N Watted, A DeRowe, A Nachmani
OBJECTIVES: To characterise the craniofacial structure by cephalometry, especially the skull base and nasopharyngeal space, in children who underwent adenoidectomy and developed persistent velopharyngeal dysfunction (VPD). DESIGN: Retrospective study. SETTING: Speech and swallowing clinic of a single academic hospital. PARTICIPANTS: Thirty-nine children with persistent VPD following adenoidectomy (mean age 8.0±3.6 years) and a control group of 80 healthy children...
March 21, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28167017/hearing-sensitivity-in-adults-with-a-unilateral-cleft-lip-and-palate-after-two-stage-palatoplasty
#7
I F P M Kappen, J B S Schreinemakers, K P Q Oomen, D Bittermann, M Kon, C C Breugem, A B Mink van der Molen
OBJECTIVE: To evaluate long-term hearing and middle ear status in patients treated for a unilateral complete cleft lip and palate (UCLP) by two-stage palatoplasty. METHODS: Forty-nine UCLP patients aged 17 years and older were included in this retrospective study. Patients were invited for a multidisciplinary long-term follow-up of their treatment at a tertiary center for craniofacial surgery in the Netherlands. ENT assessment included tympanometry and pure-tone audiometry...
March 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28028412/the-role-of-the-velopharyngeal-sphincter-in-the-speech-of-patients-with-cleft-palate-or-cleft-lip-and-palate-using-perceptual-methods
#8
Tatjana Georgievska-Jancheska, Juliana Gjorgova, Mirjana Popovska
BACKGROUND: The velopharyngeal sphincter (VPS) plays the main role in speech formation. The cleft palate, due to the damage of the soft palate, leads to dysfunction of the velopharyngeal sphincter thus causing speech disorder. AIM: To establish a link between the nasal air escape and the perceptual symptoms in the speech of patients with cleft palate or cleft lip and palate using auditory-visual perceptual procedures for determining the influence the velopharyngeal dysfunction has on speech...
December 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28011323/intensive-care-unit-monitoring-after-pharyngeal-flap-surgery-is-it-necessary
#9
Sashank Reddy, Srinivas Susarla, Nance Yuan, Gurjot Walia, Danielle Rochlin, Richard Redett
PURPOSE: To assess the incidence of perioperative complications and the utility of intensive care monitoring in patients undergoing posterior pharyngeal flap surgery for velopharyngeal dysfunction (VPD). MATERIALS AND METHODS: This study was a retrospective evaluation of patients who underwent posterior pharyngeal flap surgery for treatment of VPD and an assessment of the incidence of perioperative complications. Descriptive statistics were computed. RESULTS: Over an 18-year period, 145 patients underwent pharyngeal flap surgery for VPD; 133 (91...
December 1, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27939037/craniofacial-structure-variations-in-patients-with-palatal-anomalies-and-velopharyngeal-dysfunction
#10
Ariela Nachmani, Dror Aizenbud, Ben Nageris, Omri Emodi, Firas Kassem
PURPOSE: Cephalometric evaluation of craniofacial and craniopharyngeal morphology is important for understanding the factors affecting velopharyngeal dysfunction (VPD) in patients with palatal anomalies. MATERIALS AND METHODS: In this study, 366 patients with VPD were retrospectively stratified into cleft lip and palate (CLP), cleft palate (CP), submucous cleft palate (SMCP), occult submucous cleft palate (OSMCP), and non-CP groups. Lateral cephalometrics were used to assess craniofacial, craniopharyngeal, and velopharyngeal anatomy...
November 20, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27712815/velopharyngeal-dysfunction-evaluation-and-treatment
#11
REVIEW
Jeremy D Meier, Harlan R Muntz
Velopharyngeal dysfunction (VPD) can significantly impair a child's quality of life and may have lasting consequences if inadequately treated. This article reviews the work-up and management options for patients with VPD. An accurate perceptual speech analysis, nasometry, and nasal endoscopy are helpful to appropriately evaluate patients with VPD. Treatment options include nonsurgical management with speech therapy or a speech bulb and surgical approaches including double-opposing Z-plasty, sphincter pharyngoplasty, pharyngeal flap, or posterior wall augmentation...
November 2016: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/27703866/hypernasality-associated-with-basal-ganglia-dysfunction-evidence-from-parkinson-s-disease-and-huntington-s-disease
#12
Michal Novotný, Jan Rusz, Roman Čmejla, Hana Růžičková, Jiří Klempíř, Evžen Růžička
BACKGROUND: Although increased nasality can originate from basal ganglia dysfunction, data regarding hypernasality in Parkinson's disease (PD) and Huntington's disease (HD) are very sparse. The aim of the current study was to analyze acoustic and perceptual correlates of velopharyngeal seal closure in 37 PD and 37 HD participants in comparison to 37 healthy control speakers. METHODS: Acoustical analysis was based on sustained phonation of the vowel /i/ and perceptual analysis was based on monologue...
2016: PeerJ
https://www.readbyqxmd.com/read/27701628/effects-of-biofeedback-on-control-and-generalization-of-nasalization-in-typical-speakers
#13
Elizabeth S Heller Murray, Joseph O Mendoza, Simone V Gill, Joseph S Perkell, Cara E Stepp
Purpose: The purpose of this study was to determine the effects of biofeedback on control of nasalization in individuals with typical speech. Method: Forty-eight individuals with typical speech attempted to increase and decrease vowel nasalization. During training, stimuli consisted of consonant-vowel-consonant (CVC) tokens with the center vowels /a/ or /i/ in either a nasal or nonnasal phonemic context (e.g., /mim/ vs. /bib/), depending on the participant's training group...
October 1, 2016: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/27607112/long-term-surgical-and-speech-outcomes-following-palatoplasty-in-patients-with-treacher-collins-syndrome
#14
Michael S Golinko, Etoile M LeBlanc, Andrew M Hallett, Michael Alperovich, Roberto L Flores
BACKGROUND: Cleft palate is present in one-third of patients with Treacher-Collins syndrome. The authors present long-term speech and surgical outcomes of palatoplasty in this challenging patient population. METHODS: A retrospective review of all patients with Treacher-Collins syndrome and cleft palate was conducted over a 35-year period at a single institution. Demographics, palatal, mandibular, airway, and surgical outcomes were recorded. Speech outcomes were assessed by the same craniofacial speech pathologist...
September 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27484234/perceptual-assessment-of-velopharyngeal-dysfunction-by-otolaryngology-residents
#15
MULTICENTER STUDY
Sydney C Butts, Alan Truong, Christina Forde, Dimitre G Stefanov, Eileen Marrinan
OBJECTIVE: To assess the ability of otolaryngology residents to rate the hypernasal resonance of patients with velopharyngeal dysfunction. We hypothesize that experience (postgraduate year [PGY] level) and training will result in improved ratings of speech samples. STUDY DESIGN: Prospective cohort study. SETTING: Otolaryngology training programs at 2 academic medical centers. SUBJECTS AND METHODS: Thirty otolaryngology residents (PGY 1-5) were enrolled in the study...
December 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/27427931/size-of-velopharyngeal-structures-after-primary-palatoplasty
#16
Ana Flavia Rodrigues da Silva, Jeniffer de Cássia Rillo Dutka, Adna Maressa Pereira do Amaral, Maíra de Souza Périco, Maria Inês Pegoraro-Krook
OBJECTIVE:   To describe and compare measures of velar length, velar thickness, and depth of the nasopharynx between two groups of patients with velopharyngeal dysfunction after primary palatoplasty: one received the modified Langenbeck procedure and the other the Furlow procedure. DESIGN:   Comparative study involving a convenience sample of videofluoroscopic films established prospectively. SETTING:   Surgeries and videofluoroscopic assessments were conducted at a craniofacial center...
September 2017: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/27260592/speech-characteristics-after-articulation-therapy-in-children-with-cleft-palate-and-velopharyngeal-dysfunction-a-single-case-experimental-design
#17
Fatemeh Derakhshandeh, Mohammadreza Nikmaram, Hedieh Hashemi Hosseinabad, Mehrdad Memarzadeh, Masoud Taheri, Mohammadreza Omrani, Shohreh Jalaie, Mahmood Bijankhan, Debbie Sell
OBJECTIVE: The aim of this study was to investigate the impact of an intensive 10-week course of articulation therapy on articulation errors in cleft lip and palate patients who have Velopharyngeal Insufficiency (VPI), non-oral and passive cleft speech characteristics. METHODS: Five children with cleft palate (+/-cleft lip) with VPI and non-oral and passive cleft speech characteristics underwent 40 intensive articulation therapies over 10 weeks in a single case experimental design...
July 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27218023/postoperative-speech-outcomes-and-complications-in-submucous-cleft-palate-patients
#18
Tae Seo Park, Yong Chan Bae, Su Bong Nam, Kyung Dong Kang, Ji Yoon Sung
BACKGROUND: The postoperative speech outcomes of submucous cleft palate (SMCP) surgery are known to be poorer than those of other types of cleft palate. We attempted to objectively characterize the postoperative complications and speech outcomes of the surgical treatment of SMCP through a comparison with the outcomes of incomplete cleft palate (ICP). METHODS: This study included 53 SMCP patients and 285 ICP patients who underwent surgical repair from 1998 to 2015...
May 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27198193/a-human-model-of-restricted-upper-esophageal-sphincter-opening-and-its-pharyngeal-and-ues-deglutitive-pressure-phenomena
#19
Hongmei Jiao, Ling Mei, Tarun Sharma, Mark Kern, Patrick Sanvanson, Reza Shaker
Oropharyngeal dysphagia due to upper esophageal sphincter (UES) dysfunction is commonly encountered in the clinical setting. Selective experimental perturbation of various components of the deglutitive apparatus can provide an opportunity to improve our understanding of the swallowing physiology and pathophysiology. The aim is to characterize the pharyngeal and UES deglutitive pressure phenomena in an experimentally induced restriction of UES opening in humans. We studied 14 volunteers without any dysphagic symptoms (7 men, 66 ± 11 yr) but with various supraesophageal reflux symptoms...
July 1, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/27150305/diagnosis-and-management-of-velopharyngeal-dysfunction
#20
REVIEW
Robert S Glade, Randolph Deal
Velopharyngeal dysfunction (VPD) describes any condition whereby the velopharyngeal valve does not properly close during the production of oral sounds. VPD contains multiple causes, including velopharyngeal mislearning (nasopharyngeal sound substitution for an oral sound), velopharyngeal incompetence (neurolophysiologic dysfunction causing poor pharyngeal movement), and velopharyngeal insufficiency (a structural or anatomic defect prevents velopharyngeal closure). Evaluation for VPD is best performed within the context of a multidisciplinary team and consists of history and physical examination, perceptual speech evaluation, and instrumental assessment of speech with either video nasoendoscopy or multiview speech fluoroscopy...
May 2016: Oral and Maxillofacial Surgery Clinics of North America
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