Objective and subjective evaluation of Velopharyngeal Dysfunction (VPD) following surgical repair of the cleft palate using the furlow palatoplasty - A new tool

Mi, Rizzo; Fallico, Nefer; Beneduce, N; Ruoppolo, Giovanni; Ciofalo, Andrea; Vagnoni, Salvatore; Palmieri, Annapina; Virgilio, Antonio; Greco, A; Zama, Mario

doi:10.1016/j.bjps.2022.02.024

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…While exhaustive research has been done to assess the result of such repairs subjectively by evaluating the quality of speech, very little work has been done to assess speech objectively. In the recent publication by Rizzo et al, 3 subjective and objective analyses of repaired palates were compared in terms of speech improvement, which is the effect of the repair. Since even a well-repaired palate might sometimes not be able to produce the satisfactory speech desired due to the need for speech therapy, it is imperative to understand if the problem in speech lies in the structural anatomical reconstruction or in the dearth of adequate speech therapy.…”

Section: Introductionmentioning

confidence: 99%

Estimating Palatal and Pharyngeal Muscle Contraction in Hindi Syllable Pronunciation using Computational Modeling

Vathulya,

Sarkar,

Singh

et al. 2024

Indian J Plast Surg

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Introduction Speech, one of the main functions affected by cleft palate, involves a complex orchestra of sound deformation by various organs including the larynx, pharynx, epiglottis, palate, tongue, lip, and other structures complementing them. Although the effects of palatoplasty are traditionally evaluated subjectively, objective parameters have seldom been described to compare the pre- and postrepair functions. The study tries to extract the palatal and pharyngeal muscles while uttering various Hindi syllables and tries to find the percentage contraction of these structures as an objective assessment. Materials and Methods Digital Imaging and Communications in Medicine (DICOM) images while uttering each syllable of the Hindi syllable are obtained by subjecting a healthy volunteer to a dynamic magnetic resonance imaging (MRI). Using freeform geomagic software, 3D models of the structure of the pharynx and palate were created, which were then used to create a finite element model. Different anatomical constraints were applied to the muscles obtained. The finite element model was tested for convergence and a suitably fine mesh was used to obtain the results. The percentage of contraction of the palate and pharynx for uttering different syllables was thus evaluated. Results The palate and the posterior pharyngeal walls yielded different contractions for different syllables independent of each other. The highest contraction for the palate and posterior pharyngeal wall was for the syllable /k/ and the lowest regarding the palate was for /h/ and /eː/ for the pharyngeal wall. Conclusion Using computational modeling, quantification of speech in terms of percentage contraction of the palate and pharynx has been attempted for the Hindi language. Once validated with a larger population, the database may be used to quantify speech deformities due to structural pathologies in terms of palatal and pharyngeal contractions and help us assess the effectiveness of corrective surgeries for them.

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Section: Introductionmentioning

confidence: 99%

Estimating Palatal and Pharyngeal Muscle Contraction in Hindi Syllable Pronunciation using Computational Modeling

Vathulya,

Sarkar,

Singh

et al. 2024

Indian J Plast Surg

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Rhinomanometry evidence in children treated by Furlow’s palatoplasty for velopharyngeal insufficiency correlated to cleft palate

Rizzo,

Fallico,

Palmieri

et al. 2024

Il Giornale Di Chirurgia - Journal of the Italian Association of Hospital Surgeons

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Background: Speech surgery outcomes for velopharyngeal insufficiency (VPI) are difficult to quantify. We investigated the correlation between objective measurements of nasal emission and speech assessment ratings in children undergoing Furlow palatoplasty for the treatment of cleft-related VPI. Methods: A total of 20 patients with VPI after primary cleft palate repair were recruited for Furlow’s palatoplasty. All participants completed rhinomanometry (RM) and speech evaluation scored by two blinded speech-language pathologists. Pre- and postoperative results were compared using the paired t test. Statistical significance was set for P values < 0.05. Correlation tests were performed to identify the correspondence of the RM findings with the speech assessment ratings. Results: RM quantified a reduction of the expiratory flow postoperatively. The sensitivity for the RM was 1.00 and the specificity 0.95. The mean of the pre- versus postoperative values was 0.52 ± 0.43 (range: 0.14–1.69) versus 0.51 ± 0.54 (range: 0.18–1.8), P < 0.05. These values confirmed a reduction of the nasal emission postoperatively, which was consistent with the speech assessment reports. Conclusions: Combined subjective and objective measurements can complete the clinical assessment of these patients. RM measurements confirmed the velopharyngeal changes achieved with speech surgery.

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Objective and subjective evaluation of Velopharyngeal Dysfunction (VPD) following surgical repair of the cleft palate using the furlow palatoplasty - A new tool

Cited by 2 publications

References 24 publications

Estimating Palatal and Pharyngeal Muscle Contraction in Hindi Syllable Pronunciation using Computational Modeling

Estimating Palatal and Pharyngeal Muscle Contraction in Hindi Syllable Pronunciation using Computational Modeling

Rhinomanometry evidence in children treated by Furlow’s palatoplasty for velopharyngeal insufficiency correlated to cleft palate

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