Relationship between velopharyngeal closure, hypernasality, nasal air emission and nasal rustle in subjects with repaired cleft palate

Abstract

There is significant correlation between velopharyngeal closure and hypernasality, NAE and NR. It suggests that the perceptual speech characteristics can predict velopharyngeal closure, favoring the diagnosis and the definition of treatment conduct of velopharyngeal dysfunction.

Influência da amostra de fala na classificação perceptiva da hipernasalidade

“…Researches report that the judgments of speech symptoms made by different raters are not comparable and that experience in the assessment of individuals with cleft palate does not guarantee a high level of concordance (25) . Inter-rater agreement coefficients similar to those found in this study have been verified by authors for both types of speech sample, which ranged from moderate to substantial (13,26) , moderate (3,9,17,24) , regular to moderate (18) and regular (20) . It is noteworthy that no other study in the literature, to date, compared the ratings of hypernasality degree in different types of speech sample for the same individual.…”

“…Significant intra-raters agreement using repeated sentences and standardized words were shown in previous studies of the Institution, which ranged from substantial to almost perfect (16,17) , moderate to almost perfect (18,19) and regular to almost perfect (20) . Others studies present percentage of intra-rater agreement above 80% (21)(22)(23) .…”

The Role of the Velopharyngeal Sphincter in the Speech of Patients with Cleft Palate or Cleft Lip and Palate Using Perceptual Methods

“…Still, a certain number of authors, one of which is Scarmagnani et al [21], points out that there is a considerable correlation between the size of the velopharyngeal closure and the level of nasal air escape in patients with a corrected cleft palate which, in fact, overlaps with the result from our research. However, unlike this research, Scarmagnani uses various researching methods (aerodynamic speech assessment and audio-digital speech recording) and different statistical analysis (Spearman’s rank correlation coefficient).…”

Elaboração de um instrumento para predizer o fechamento velofaríngeo com base nas características de fala e sua correspondência com as dimensões do orifício velofaríngeo

“…A hipernasalidade é a ressonância excessiva durante a produção das vogais e consoantes vozeadas (SWEENEY, 2011;ASTEN;AKRE;PERSSON, 2014;BAYLIS et al, 2015 (SCARMAGNANI et al, 2014;SCARMAGNANI et al, 2015;BAYLIS et al, 2015) emissão turbulenta de ar nasal (BAYLIS et al, 2015), e fricativa nasal passiva (HARDING; GRUNWELL, 1998). Trata-se de um fenômeno acústico, que ocorre principalmente em consoantes obstruintes, especialmente, as não vozeadas (ZAJAC; VALLINO, 2016).…”

“…A despeito do fato de que as avaliações instrumentais são eficazes para identificar e quantificar objetivamente e de forma detalhada aspectos da fala não identificáveis ou quantificáveis pelos olhos ou ouvidos humanos, nenhuma análise instrumental pode descrever a fala como um ouvinte ou, ainda, como um avaliador experiente (LOHMANDER; HOWARD, 2011;BAYLIS et al, 2015). Assim, ambos os métodos devem ser empregados como valiosos recursos complementares especialmente considerando a comprovada correlação entre os sintomas de fala e a extensão da falha velofaríngea (KUMMER et al, 1992;MAYO, 1994;BRIGGS;LEE, 2003;LIPIRA et al, 2011;MA et al, 2013;SCARMAGNANI et al, 2015). Diversos protocolos foram elaborados a fim de se classificar o funcionamento velofaríngeo PHILIPS, 1979;TRINDADE et al, 2005;JOHN et al, 2006), porém, nenhum deles utilizou, para este fim, um instrumento objetivo somado à avaliação perceptiva, como foi realizado no presente estudo.…”