Fissura palatina reparada: fechamento velofaríngeo antes e durante o som basal

Abstract

Patients with palatine fissure have inadequate velopharyngeal closure (VPC), with consequent vocal hypernasality which can be reduced by a basal tone. Aim: to compare VPC during a basal tone with the emission of a modal recording, in patients with repaired post-foramen palatine fissure. Materials and methods: case study with four adult men, all with repaired post-foramen palatine fissure. VPC images through nasal-pharyngoscopy during the emission o f the [a] vowel in a modal and basal recording. The images were studied by four ENTs. Results: in three subjects there was no change in the type of VPC considering the recordings analyzed; the changes which happened to most of the subjects are associated only to the degree of movement of the structures involved, since in the basal recording the movement of the laryngeal lateral walls was kept, the movement of the posterior pharyngeal wall stabilized, the movement of the palatine veil was mildly reduced, and the Passavant fold was evident. Conclusions: The type of VPC was kept in the four subjects analyzed, when we compared the modal and basal recordings, there was a modification in the degree of movements in the structures involved, making it clear the Passavant Fold.

Músculo tiroaritenoideo e som basal: uma revisão de literatura

“…Emissions in this register show high levels of jitter, shimmer and noise when compared to the modal register commonly used in spontaneous speech (1,18,19,(32)(33)(34)(35) . However, there is no consensus regarding the definition of "vocal register" (1,3,4,18,19,26,27) , in relation to the exact range of frequencies produced in BR (1,3,4,6, 7,9,18,19,21,27,29,30,32-35,38) , nor on the number of glottic pulses that occurs per vibration cycle in this register (1,3,4,6,7,9,18,19,21,27,28,(30)(31)(32)(33)(34)(35)(36) .…”

“…The vocal processes of the arytenoids appear to be leveraged anterior and medially and may further reduce the posterior glottic gap (18) . The thickening of the vocal folds, together with the decreased stiffness of the vocal ligament during the BR may be the main contributing factors to reduce the speed of vocal fold vibration by altering the characteristics of the vibratory cycle, in which the vocal folds open and close from one to three times in rapid succession (depending on the author) and after that, they come to a closed position for a longer period of time, in a vibration pattern of pulses that also characterizes this register (1,3,4,6,7,9,18,19,21,28,(30)(31)(32)(33)(34)(35)(36) .…”

“…Regarding different genders , it is common to both, men and women, two main features of the BR: The occurrence of multiple opening and closing phases to each vibratory cycle (glottal pulses) (1,3,4,6,7,9,18,19,21,27,28,(30)(31)(32)(33)(34)(35)(36) and the same range of frequencies in its production (1,3,4,6,7,9,18,19,21,29,30,(32)(33)(34)(35)38) . In addition, men and women had significantly high contact ratio between the vocal folds during BR when compared to the modal register (30) in an electroglottography.…”

Effect of Vocal Fry on Voice and on Velopharyngeal Sphincter

“…It works as a valve that closes as a sphincter, separating the nasal and oral cavity, The action of the VPS and its structural integrity are very important to determine nasal resonance and intraoral pressure, which are necessary for the articulation of certain phonemes. 1 2 3 4 5 6 7 …”

“…These difficulties relate to changes in voice resonance (hypernasality) and speech articulation (nasal substitution, compensatory articulation and lisping). 1 2 3 4 5 11 Hypernasality shows very strong negative social connotation and, therefore, it represents a stigma for people with a cleft palate. 1 3 6 9 10 11 12 13 …”