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velopharyngeal incompetence

Abdel Rahim M Bibars, Firas S D Alfwaress, Abed Al-Hadi Hamasha, Zeid A Al-Hourani, Khader Almhdawi
BACKGROUND: Hypernasality is a frequently encountered problem in the speech of individuals with velopharyngeal incompetence. The use of palatal lift appliance (PLA) is the main treatment option for correction of velopharyngeal incompetence. The literature on the outcomes of using prosthetics treatment for Arabic speaking patients is scarce. OBJECTIVE: The aim of this study was to investigate the effect of using PLA on hypernasality of Arabic speaking patients with velopharyngeal incompetence...
2017: Open Dentistry Journal
Himija Karia, Sunita Shrivastav, Ashok Kumar Karia
INTRODUCTION: Patients with cleft lip and palate (CLP) suffer from several esthetic and functional challenges. Comprehensive treatment of these patients involves orthognathic surgery that may lead to velopharyngeal insufficiency or reduction in lower airway. Several cases of airway insufficiency, velopharyngeal incompetence, snoring, hypopnea, and obstructive sleep apnea have been reported in subjects with CLP. The aim of this study was to compare the anteroposterior dimensions of the oropharyngeal airway at 5 levels, the height of the oropharyngeal column, and the volume of the oropharyngeal airway in subjects with and without CLP...
September 2017: American Journal of Orthodontics and Dentofacial Orthopedics
Yin Heng, Guo Chunli, Shi Bing, Li Yang, Li Jingtao
OBJECTIVE: To characterize the velopharyngeal closure patterns and speech performance among submucous cleft palate patients. METHODS: 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...
June 1, 2017: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
Yu-Jeong Shin, Yongsoo Kim, Hyun-Gi Kim
BACKGROUND: Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. METHODS: Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this experimentation...
December 2017: Maxillofacial Plastic and Reconstructive Surgery
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...
2017: Clinical Linguistics & Phonetics
Shi Bing, Fu Yuchuan, Yin Ningbei, Huang Hong-Zhang, Liu Jianhua, Chen Renji, Zhu Hongping, Liu Qiang, Huang Yongqing, Ren Zhanping, Lu Yong, Xiao Wenlin, Song Qinggao, Li Wanshan, Li Sheng, Wang Hongtao, Zhang Junrui, Jiang Liping, Ma Li, Wang Ling, He Dengqi
The development of an expert consensus based on specific domestic situations will provide practical guidance to the efforts aiming at improving cleft care in China. The team approach of twenty-one cleft centers were pooled together, covering pre-surgical orthopedics, primary surgical repair, orthodontic treatment, alveolar bone graft, secondary deformity correction, palatal fistulae repair, the diagnosis and treatment of velopharyngeal incompetence, speech therapy, otitis media management, and skeletal deformity correction...
February 1, 2017: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
Jorma Rautio, Mikael Andersen, Stig Bolund, Jyri Hukki, Hallvard Vindenes, Peter Davenport, Kjartan Arctander, Ola Larson, Anders Berggren, Frank Åbyholm, David Whitby, Alan Leonard, Jan Lilja, Erik Neovius, Anna Elander, Arja Heliövaara, Phil Eyres, Gunvor Semb
BACKGROUND: Longstanding uncertainty surrounds the selection of surgical protocols for unilateral cleft lip and palate, and randomised trials have only rarely been performed. The Scandcleft Project consists of three trials commenced in 1997 involving ten centres in Denmark, Finland, Norway, Sweden, and the UK. Three groups of centres tested a newly-defined common technique for palatal repair (Arm A) against their local protocols (Arms B, C, D). Arm A was familiar to most of the surgeons in Trial 1, but not to the surgeons in the other Trials...
February 2017: Journal of Plastic Surgery and Hand Surgery
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
Tomohisa Ohno, Norimasa Katagiri, Ichiro Fujishima
A palatal lift prosthesis (PLP) is an intraoral device that provides lift for the soft palate. The usual purpose of a PLP is to reduce nasopharyngeal reflux and the hypernasal speech caused by velopharyngeal incompetence. However, for this patient, the main purpose was to relieve a functional blockage at the oropharyngeal isthmus by suspending the soft palate. A PLP with soft and flexible lift was applied in a patient with a traumatic brain injury and dysphagia. The PLP improved oropharyngeal bolus transit time by relieving the blockage at the oropharyngeal isthmus...
August 2017: Journal of Prosthetic Dentistry
AnnaKarin Larsson, Johnna Schölin, Hans Mark, Radi Jönsson, Christina Persson
BACKGROUND: In the last decade, a large number of children with cleft lip and palate have been adopted to Sweden. A majority of the children were born in China and they usually arrive in Sweden with an unoperated palate. There is currently a lack of knowledge regarding speech and articulation development in this group of children, who also have to deal with a late first language switch. AIMS: To study consonant proficiency in 3-year-old internationally adopted children with unilateral cleft lip and palate (UCLP) compared with peers with UCLP born in Sweden...
January 24, 2017: International Journal of Language & Communication Disorders
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
J Pauchot, D Feuvrier, I Pluvy, F Floret, O Mauvais
INTRODUCTION: Reconstruction of the soft palate after oncologic resection remains a surgical challenge. Speech and swallowing problems are the consequences of velopharyngeal incompetence following soft palate resection. Free tissue transfer like radial forearm flaps can be used in larger defects for complex reconstruction. The conformation of the flap in order to be closer to the shape of the soft palate improves the functional outcome. In the same way, we describe an original "double-arched" flap design...
December 2016: Annales de Chirurgie Plastique et Esthétique
Paul Luther Shay, Jesse A Goldstein, Jason D Wink, J Thomas Paliga, Cynthia B Solot, Marilyn A Cohen, Susan A Friedman, David W Low, Jesse A Taylor, Oksana A Jackson
BACKGROUND: International adoptees with cleft lip and palate (CLP) are a growing population in the United States. They represent a clinical challenge, presenting at various ages and stages of cleft repair. METHODS: A retrospective review of patients seen at the CLP Program at the Children's Hospital of Philadelphia (CHOP) between 1998 and 2012 with a history of international adoption was performed. Demographics, surgical histories, and long-term speech outcomes were reviewed...
October 2016: Annals of Plastic Surgery
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
J Erdenetsogt, G N Ayanga, D Tserendulam, R Bayasgalan
INTRODUCTION: The three common complications after cleft palate repair are velopharyngeal incompetence, delayed maxillary growth, and fistula formation. Fistula formation rates are reported 0-76% in the literature. Wider palatal defects are more challenging to avoid excess tension, and recent reports suggest defects >15 mm have a significantly higher risk of fistula formation. By localization, the fistulas are divided into seven groups with Pittsburgh fistula classification system (PFCS)...
July 2015: Annals of Maxillofacial Surgery
Joseph T Hardwicke, Helen Richards, Louise Cafferky, Imogen Underwood, Britt ter Horst, Rona Slator
BACKGROUND: Pierre Robin sequence results from a cascade of events that occur during embryologic development and frequently presents with cleft palate. Some studies have shown speech outcomes to be worse in patients with Pierre Robin sequence after cleft palate repair. METHODS: A cohort of Pierre Robin sequence patients who all required an airway intervention and nasogastric feeding in the neonatal period were identified and speech outcomes assessed at 5 years of age...
March 2016: Plastic and Reconstructive Surgery
Ezzeddin Elsheikh, Mohammad Waheed El-Anwar
OBJECTIVE: To describe and assess the results of central inset L-shaped posterior pharyngeal flap (PF) for treatment of velopharyngeal incompetence. METHODS: This study included 12 patients who were diagnosed as persistent velopharyngeal insufficiency. L-shaped central inset superiorly based PF was harvested from oropharynx and inserted into the soft palate through a transverse full-thickness palatal incision 1 cm behind the posterior margin of the hard palate, then the flap was spread 1 cm horizontally and 1 cm in the anteroposterior direction in soft palate...
January 2016: Journal of Craniofacial Surgery
Nikhila Raol, Gillian Diercks, Cheryl Hersh, Christopher J Hartnick
Stress velopharyngeal incompetence (SVPI) commonly affects brass and wind musicians. We present a series of two patients who presented with nasal air emission following prolonged woodwind instrument practice. Neither patient demonstrated audible nasal air emission during speech, but endoscopy revealed localized air escape/bubbling from different sites for each patient with instrument playing only. Both underwent tailored surgical treatment with resolution of symptoms during performance. Diagnosis of SVPI requires examination during the action that induces VPI to allow for directed management...
December 2015: International Journal of Pediatric Otorhinolaryngology
Valérie Bedoucha, François Boutin, Laure Frapier
AIM: Mouth breathing is a functional disorder that affects craniofacial and dento-alveolar growth and also upper airway (UA) anatomy. This is apparent mainly in dimensional abnormalities of the UA caused by hypertrophy of Waldeyer's ring and excessive vertical development of the lower part, giving rise to labial incompetence that perpetuates the functional disorder. The main aim of this study was to evaluate the development of the oropharyngeal structures in young hyperdivergent patients who had undergone functional genioplasty in the context of orthodontic treatment...
December 2015: International Orthodontics
Hidemi Yoshimasu, Yutaka Sato, Takashi Mishimagi, Akihide Negishi
BACKGROUND: Velopharyngeal function is very important for patients with cleft palate to acquire good speech. For patients with velopharyngeal insufficiency, prosthetic speech appliances and speech therapy are applied first, and then pharyngeal flap surgery to improve velopharyngeal function is performed in our hospital. The folded pharyngeal flap operation was first reported by Isshiki and Morimoto in 1975. We usually use a modification of the original method. PURPOSE: The purpose of this research was to introduce our method of the folded pharyngeal flap operation and report the results...
January 2015: Annals of Maxillofacial Surgery
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