Acoustic analysis of voice in children with cleft palate and velopharyngeal insufficiency

Effect of Vocal Fry on Voice and on Velopharyngeal Sphincter

“…In an investigation, 14 children who had gap in the VPS region, due to the repaired cleft lip and palate, were compared with 14 normal subjects, through acoustic voice analysis. The children in the study group had higher values of jitter and shimmer than children in the control group, but when the children in the study group were compared with each other, by the gap size difference, only the shimmer was higher in those with moderate gap, when compared with those with mild gap 13 . Future research may clarify these issues.…”

“…Still, the auditory-perceptual vocal analysis in this study showed a reduction of hypernasality in all subjects ( Table 1 ), due to a larger VPS closure region in four subjects ( Table 2 ) after vocal fry phonation. The literature points to the importance of measuring this aspect through direct instrumental evaluation (nasoendoscopy) and clinical evaluation (auditory-perceptual assessment), 4 13 as was done in the present study. There is a clear association between the results of these two assessments.…”

“…The following subject inclusion criteria were established to choose the cases to be studied: surgically repaired post-foramen cleft palate 13 ; age range between 18 and 40 years, thus avoiding the influence of possible effects of voice change or presbyphonia; ability to perform vocal fry. 2 3 Exclusion criteria were: hearing loss, 11 13 since it is known that hearing is determinant in the quality and control of vocal production, and lack of auditory feedback or distortion could compromise the auditory perception of hypernasality and production of vocal fry, which may lead subjects to produce it with unnecessary effort and muscle tension; having undergone prior speech therapy, so as to avoid the fact that adequate muscle compensations may have been used to stimulate VPS closure. 2 3 …”

“…An ENT evaluation was performed in a doctor's office, by means of nasopharyngoscopy 5 6 11 13 ; the velopharyngeal function was examined. For this evaluation, the following equipment was used: VHS tape for videotaping, a Semp Toshiba Lumina Line 14-inch TV set, a Sony SLV - 66 BR 4-head Video Cassette Recorder, a Welch Allyn RL -100 Rhinolaryngoscope, a Kom Lux Fibras Ópticas - HL2250 Cold Light Source, and technology to save video-tape images into a cd room , for further image analysis with Virtual Dub video editing software and Pinacle PCTV video capture driver.…”

“…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 …”