Furlow palatoplasty has been favored by many plastic surgeons as the primary treatment for the velopharyngeal insufficiency associated with submucous cleft palate. The purpose of this article is to introduce an efficacy of Furlow palatoplasty and speech therapy performed on patients who were diagnosed belatedly as having submucous cleft palates. From 2002 to 2004, four submucous cleft palate patients over 5 years of age with velopharyngeal insufficiency received Furlow palatoplasty. The patients were evaluated through the preoperative perceptual speech assessment, nasometry, and videonasopharyngoscopy. Postoperatively, two patients achieved competent velopharyngeal function in running speech. One of the remaining two could achieve competent velopharyngeal function with visual biofeedback speech therapy and the other could not use her new velopharyngeal function in running speech because of her age. Speech therapy can correct the articulation errors and thus improve the velopharyngeal function to a certain extent by eliminating some compensatory articulations that might have an adverse influence on velopharyngeal function. This study shows that Furlow palatoplasty can successfully correct the velopharyngeal insufficiency in submucous cleft palate patients and speech therapy has a role in reinforcing surgical result. But age is still a restrictive factor even though surgery was well done.
Biofeedback, Psychology ; Cleft Palate* ; Humans ; Running ; Speech Therapy* ; Velopharyngeal Insufficiency

OBJECTIVETo assess the clinical efficacy on post-stroke speech disorder treated with acupuncture and psychological intervention combined with rehabilitation training.

METHODSThe multi-central randomized controlled study was adopted. One hundred and twenty cases of brain stroke were divided into a speech rehabilitation group (control group), a speech rehabilitation plus acupuncture group (observation group 1) and a speech rehabilitation plus acupuncture combined with psychotherapy group (observation group 2), 40 cases in each one. The rehabilitation training was conducted by a professional speech trainer. In acupuncture treatment, speech function area in scalp acupuncture, Jinjin (EX-HN 12) and Yuye (EX-HN 13) in tongue acupuncture and Lianquan (CV 23) were the basic points. The supplementary points were selected according to syndrome differentiation. Bloodletting method was used in combination with acupuncture. Psychotherapy was applied by the physician in psychiatric department of the hospital. The corresponding programs were used in each group. Examination of Aphasia of Chinese of Beijing Hospital was adopted to observe the oral speech expression, listening comprehension and reading and writing ability.

RESULTSAfter 21-day treatment, the total effective rate was 92.5% (37/40) in observation group 1, 97.5% (39/40) in observation group 2 and 87.5% (35/40) in control group. The efficacies were similar in comparison among 3 groups. The remarkable effective rate was 15.0% (6/40) in observation group 1, 50.0% (20/40) in observation group 2 and 2.5% (1/40) in control group. The result in observation group 2 was superior to the other two groups (P<0.01, P<0.001). In comparison of the improvements of oral expression, listening comprehension, reading and writing ability, all of the 3 groups had achieved the improvements to different extents after treatment (P<0.01, P<0.001). The results in observation group 2 were better than those in observation group 1 and control group.

CONCLUSIONAcupuncture and psychological intervention combined with rehabilitation training is obviously advantageous in the treatment of post-stroke speech disorder.

Acupuncture Therapy ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Speech Disorders ; etiology ; psychology ; rehabilitation ; therapy ; Speech Therapy ; Stroke ; complications

700 mentally handicapped child and children with learning disorders were investigated to find out the causes or clinical diagnosis at department of Pediatrics, Yousei Medical School. The abilities of individual child was evaluated for their further education and training. And following results were obtaine. 1. The clinical diagnosis or the cause was not able to make in 233 cases, 33.3%, out of 700. 2. The rest, 64.7%, represented various clinical diagnosis, the most common casuses were cerebral paly, microcephaly, 42.7%, 19.9% respectively. 3. Other various causes vere as follow. Mentally handicapped children related to epilepsy was 107%, children with chromosomal anomalies 4.7%, with CNS anomalies 2.1%, with vascular diseases 5.4%, endocrine disorder 2.6%, muscle disorder 3%, phagomatosis 2.7%, metabolic disorder 1%, encephalopathy and poisoning related disorder was 1% respectively. The CNS infection was 2.6%, syndromes with funny looking face without chromosomal anomalies 1.6%, Psychiatric disorder 0.7%. Developmental disorder was quite common causes of learning disorder which represented 22.2%. Among 700, children with mutism was 1.6% and blind child was 1.4%. 4. Their abilities was evaluated by Griffiths Developmental Scale and WISK testes for further education and training. 89.6% requires physiotherapy or occupational therapy, 95% required speech therapy. 5. Exact evaluation and assessment for mentally handicapped children should be based on well qualified specialistes of various fields working as a team with mutural understanding and exchanging their knowledges. Organization of assessment unit for mentally handicapped children as well as learning disorders is required for efficient assessment and training of staffes. 6. Participation of clinical psychologist and teachers during the process of assessment would great helpful not only to assessing but also teaching these children. We do know that speech therpist and occupational therapist is lack in number. And organization training project of these therapist should established soon as possible.
Child* ; Diagnosis ; Education ; Epilepsy ; Humans ; Learning Disorders ; Learning* ; Mentally Disabled Persons* ; Microcephaly ; Muscular Diseases ; Mutism ; Occupational Therapy ; Pediatrics ; Poisoning ; Psychology ; Schools, Medical ; Specialization ; Speech Therapy ; Testis ; Vascular Diseases

The cleft lip and palate (CLP) is one of the most common craniofacial malformations in humans. We collected functional magnetic resonance data of 23 CLP patients before rehabilitation training (Bclp) and 23 CLP patients after rehabilitation training (Aclp), who were performing Chinese character pronunciation tasks, and performed brain activation analysis to explore the changes of brain mechanism in CLP patients after articulation disorder rehabilitation training. The study found that Aclp group had significant activation in the motor cortex, Broca area, Wernicke area and cerebellum. While the Bclp group had weak activation in the motor cortex with a small activation range. By comparing the differences and co-activated brain regions between the two groups, we found that rehabilitation training increased the activity level of negatively activated brain areas (cerebellum, left motor area, Wernicke area, etc.) to a positive level. At the same time, the activity level of weakly activated brain areas (right motor area, Broca area, etc.) was also increased. Rehabilitation training promoted the activity level of articulation-related brain regions. So that the activation intensity of articulation-related brain regions can be used as a quantifiable objective evaluation index to evaluate the effect of rehabilitation training, which is of great significance for the formulation of rehabilitation training programs.
Humans ; Articulation Disorders/therapy* ; Brain/diagnostic imaging* ; Cleft Lip/diagnostic imaging* ; Cleft Palate/diagnostic imaging* ; Magnetic Resonance Imaging ; Speech Therapy/psychology*

Globus pharyngeus or globus sensation is the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling. It is often associated with persistent clearing of the throat, chronic cough, hoarseness, and catarrh. Its etiology remains unclear ; however, laryngopharyngeal reflux may play a role in a subset of patients. Psychogenic problems have often been thought to cause or trigger the globus sensation. Personality studies have found higher levels of alexithymia, neuroticism, and psychological distress (including anxiety, low mood, and somatic concerns) and lower levels of extraversion in patients presenting with globus. Globus patients with laryngopharyngeal reflux exhibited weaker psychological symptoms than non- laryngopharyngeal reflux globus patients, and globus patients who did not respond to proton pump inhibitor had significantly higher anxiety scores. In cases with negative clinical investigations and consistent globus symptom, other treatment strategies, including speech therapy, antidepressants, and cognitive-behavioral therapy, should be considered.
Affective Symptoms ; Airway Obstruction ; Antidepressive Agents ; Anxiety ; Common Cold ; Cough ; Extraversion (Psychology) ; Foreign Bodies ; Hoarseness ; Humans ; Laryngopharyngeal Reflux ; Pharynx ; Proton Pumps ; Sensation ; Speech Therapy

The incidence of bilateral profound hearing loss of newborns is 1 to 2 per 1,000 newborns. It is higher in infants with risk factors for hearing loss. Congenital hearing loss can cause many problems in language, learning, speech development and educational and occupational performance. Most developed countries have conducted the Universal Newborn Hearing Screening (UNHS) with automated otoacoustic emissions (AOAE) or automated auditory brainstem response (AABR). UNHS reduced the average age of identification of permanent hearing loss in infants 6 months or less after birth. This early identification and intervention of hearing loss with amplification and speech therapy optimizes communication during the early critical period of language acquisition and can improve language outcomes in children between 2 and 5 years of age. The aims of this paper are to explain the incidence of newborn hearing loss, the importance of early detection of hearing loss and intervention and newborn hearing screening methods.
Child ; Critical Period (Psychology) ; Developed Countries ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss* ; Hearing* ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Learning ; Mass Screening* ; Neonatal Screening ; Parturition ; Risk Factors ; Speech Therapy