OBJECTIVES: A stable, reliable, and easily implementable clinical diagnostic method for marginal velopharyngeal insufficiency (MVPI) was established on the basis of the subjective hearing judgement of hypernasality and objective examination of velopharyngeal closure to address the lack of unified diagnostic criteria for MVPI. METHODS: Nasopharyngeal fiberscopy and speech assessment results were collected from postoperative patients with cleft palate. These results were used to analyze the differences in the distribution of nasal resonance in patients with different velopharyngeal closure ratios and the correlation between velopharyngeal closure ratios and nasal resonance status. Mild-to-moderate hypernasality with its corresponding elopharyngeal closure ratio was employed to establish the diagnostic criteria of MVPI. The reproducibility of the criteria and whether the patients with MVPI diagnosed by using the criteria exhibited significantly different speech characteristics compared with other patients were verified. RESULTS: A strong correlation was found between velopharyngeal closure ratios and nasal resonance (P<0.001). Mild-to-moderate hypernasality mainly corresponded to velopharyngeal closure ratios ranging from 90% to 99%, and the combination of the two characteristics as the diagnostic criteria for MVPI demonstrated good consistency (Kappa value=0.789, P<0.001). Moreover, under the diagnostic criteria, significant differences in nasal resonance (P<0.001), nasal emission (P=0.007), and misarticulation (P<0.001) were found between patients with velopharyngeal insufficiency and those with MVPI. CONCLUSIONS Combining the subjective hearing judgement of mild-to-moderate hypernasality with velopharyngeal closure ratios over 90% under nasopharyngeal fiberscopy provides a reliable and effective clinical method for diagnosing MVPI.
Humans ; Velopharyngeal Insufficiency/physiopathology* ; Reproducibility of Results ; Cleft Palate/surgery* ; Male ; Female ; Child

OBJECTIVETo evaluate the velopharyngeal status of cleft palate patients after operation in silent mode by visual analog scale.

METHODSA total of 82 patients with cleft lip and palate after operation were examined by nasopharyngeal fiber endoscopy with 11 voice samples. The velopharyngeal status was evaluated by three experienced experts using qualitative method and visual analog scale (VAS) method in silent mode. The Spearman correlation relationship was analyzed between VAS value and qualitative grade. The VAS value range of 10 non-nasal consonant voice samples was divided according to qualitative classification.

RESULTSVAS values could accurately reflect the outcome of the qualitative classification. The poorer the velopharyngeal status was, the lower the VAS value, and vice versa. The whole effectiveness of value range was greater than 70%.

CONCLUSIONSVAS values can accurately reflect the outcome of the qualitative classification about velopharyngeal function, and VAS value grading velopharyngeal status is reliable. This study proposed VAS values range standards for different velopharyngeal qualitative classification.

Adolescent ; Adult ; Child ; Child, Preschool ; Cleft Palate ; complications ; physiopathology ; surgery ; Female ; Humans ; Male ; Postoperative Period ; Velopharyngeal Insufficiency ; etiology ; physiopathology ; Visual Analog Scale ; Young Adult

OBJECTIVETo analyze the formant frequency of vowels in the sequence therapy of patient with cleft palate.

METHODSThe formant frequency of vowels [a], [e], [i], [u] of normal children and postoperative patients with and without speech therapy was measured and analyzed by VS-99.

RESULTS1. The mean value of F1, F2, F3 of [a] did not show significant difference among the three groups (P > 0.05). 2. The difference of mean value of [e] was significant between control group and pre-speech-therapy group, and between pre-speech-therapy and post-speech-therapy group (P < 0.05), but no significant difference was found between post-speech-therapy and control group(P > 0.05). The mean value of the formant in post-speech-therapy was higher than that of pre-speech-therapy. 3. The difference of mean value of [i] was significant between pre-speech-therapy and post-speech-therapy (P < 0.05), the mean value of F2, F3 in post-speech-therapy group decreased significantly compared with control (P < 0.05). 4. The difference of mean value of [u] showed significance between pre-speech-therapy and post-speech-therapy (P < 0.05), while the differences among other groups were insignificant (P > 0.05).

CONCLUSIONSurgical repair of cleft palate cannot make all patients obtain perfect Velopharyngeal competence (VPC), while speech therapy can improve patient's pronunciation. Speech spectrum analysis can judge the effect of cleft palate therapy objectively.

Adolescent ; Adult ; Articulation Disorders ; etiology ; physiopathology ; Child ; Cleft Palate ; complications ; physiopathology ; surgery ; Female ; Humans ; Male ; Postoperative Period ; Sound Spectrography ; Speech ; physiology ; Speech Articulation Tests ; Speech Production Measurement ; Speech Therapy ; Velopharyngeal Insufficiency ; etiology ; physiopathology