Nasal Sentence Research Articles

Functional outcome of septoplasty

Background Deviated nasal septum is the most common nasal deformity, and hence septoplasty is the most commonly performed procedure for nasal airway obstruction. Preoperative and postoperative alterations in nasal function and nasalance scores represent an interesting area of research. Purpose The purpose of this work was to assess the outcome of septoplasty from the functional point of view, regarding nasal obstruction and degree of resonance. Patients and methods This study included 20 patients with symptomatized septal deviation, confirmed by computed tomography scan. Preoperative and postoperative nasal obstruction symptom evaluation scores were assessed, and preoperative and postoperative nasalance scores of nasal sentence and nasal sound and oral sentence and oral sound were measured by nasometry. Results On comparing preoperative and postoperative results, highly significant statistical differences were found in nasal obstruction symptom evaluation scores (mean±SD=2.45±1.70 vs =18.95±0.76;P<0.001**), nasalance scores of nasal sentence and nasal sound (mean±SD=26.20±4.14 vs =51.28±2.96; P<0.001**), and oral sentence and oral sound (mean±SD=8.80±1.20 vs =10.50±0.83; P<0.001**). A negative significant correlation between preoperative and postoperative total nasal obstruction symptom evaluation scores and nasalance scores of nasal sentence and nasal sound and oral sentence and oral sound was found. Conclusion Septoplasty improves the nasal obstruction symptom evaluation scores and degree of resonance.

Normative nasalance scores in Tamil-speaking Indian children

Objective The aim of this study was to obtain normative nasalance scores for Indian Tamil-speaking children. Methods Mean nasalance scores were obtained from 175 consecutive Tamil-speaking normal children (95 males, 80 females) aged 5–16 years during the repetition of six standardized sentences: two oral, two oronasal, and two nasal sentences. The nasal view was used to obtain nasalance scores for the standardized sentences Results Group mean and standard deviation (SD) nasalance scores of children for oral, oronasal, and nasal sentence were 35.65(SD 7.20), 44.42(SD 7.37), and 57.21(SD 8.15), respectively. The mean nasalance values of children aged 9–12 years were greater than children aged 5–8 years and 13–16 years for nasal sentences (p < .001). Males were found to have significantly higher nasalance scores for oral and oronasal sentences (p < .05) although these differences were within the range of normal variation. Conclusions The present study provides normative nasalance scores for Tamil-speaking Indian children.

Nasalance scores of Egyptian hearing impaired children

Context Speech of prelingual hearing impaired (HI) speakers is commonly characterized by the presence of resonance abnormalities which is related with nasality. Aim To investigate and compare nasalance scores of Egyptian HI children including cochlear implant (CI) and hearing aid (HA) users with normal hearing (NH) children. Settings and design It is an observational case–control study. Patients and methods The study consisted of group I: 41 HA children, group II: 24 CI children, and the control group: 31 age-matched and sex-matched children with NH. Nasometer II 6200 was used for evaluation of their nasalance scores. Statistical analysis used IBM SPSS, version 20, was used. Kruskal–Wallis and one-way analysis of variance tests were performed to compare the mean differences between the nasalance scores of the three studied groups. While Mann–Whitney and post-hoc tests were used for pairwise comparison. A correlation analysis was computed between the nasalance scores and many parameters using Spearman's and Pearson's coefficients. Results For oral sentence, both CI and HA children showed higher nasalance values in comparison with NH children. However, lower nasalance scores were observed for the nasal sentence. CI experience and enrollment into language therapy were found to have an effect on nasalance scores. Conclusion Resonance quality of the HI children is still at risk despite the fact that a significant number of them demonstrate normal resonance.

Normal Patterns of Nasometric Values in Adult Jordanian Speakers of Arabic.

The study sought to establish normative nasometric values for adult Jordanian speakers of Arabic. Gender-related differences and intraspeaker variability of nasalance scores were investigated. A total of 113 adult speakers of Jordanian Arabic (56 men and 57 women) without speech-language and hearing impairments or craniofacial anomalies ranging in age between 18 and 55 participated in the study. Nasometer II, Model 6400 was used to obtain nasalance scores as speakers produced 3 recitations for each of the 3 standardized passages consisting of an oral passage, an oronasal passage, and nasal sentences. Descriptive statistics of nasalance scores for each passage were obtained and gender-related differences were determined by ANOVA. Standard deviation for the 3 repetitions for each passage was considered an index for intraspeaker variability. Average nasalance for each passage was (11.23%) for the oral passage, (25.48%) for the oronasal passage, and (51.92%) for the nasal sentence. There was no gender effect on nasalance on the oral passage, however women exhibited higher nasalance scores than men on the both oronasal passage (P = 0.002) and nasal sentences (P = 0.017). Intraspeaker variability for all speakers fell below 4.5% with repeated readings. The study provides normative nasometric data for Arabic speaking Jordanian adults to serve as references for the assessment of velopharyngeal dysfunction in craniofacial clinics. Arabic speakers demonstrated different nasalance scores than speakers of other languages. Gender differences can be attributed to variations in anatomical structure and velopharyngeal function between men and women.

Evaluating Nasalance Values Among Bilingual Mandarin-English Speakers.

The goals of this research are (1) to establish normative nasalance values for bilingual Mandarin-English speakers and compare values to those of previously reported monolingual Mandarin speakers, and (2) to examine whether sex, age, dialect, and language proficiency affect levels of nasalance among Mandarin-English speakers in both English and Mandarin. All participants recorded the speech stimuli, constructed to include oral sentences, nasal sentences, oronasal sentences, and vowels /ɑ, i, u/ in Mandarin and English. Nasalance measurements were recorded using the Nasometer II 6450. A total of 45 (20 males and 25 females) native Mandarin speakers between 20 and 54 years of age from mainland China participated in the study. Mean nasalance scores of the Mandarin oral sentence (Mean [M] = 17.64, standard deviation [SD] = 7.33), oronasal sentence (M = 54.62, SD = 7.81), and nasal sentence (M = 68.73, SD = 8.09) are reported. Mean nasalance scores of the English oral sentence (M = 20.02, SD = 7.83), oronasal sentence (M = 58.71, SD = 7.59), and nasal sentence (M = 65.27, SD = 7.45) are reported. A repeated measures analysis of variance showed significant sex difference in nasalance scores for English stimuli ( P = .031) and Mandarin stimuli ( P = .040). There was no significant effects of age, dialect, and language proficiency on Mandarin or English stimuli. This is the first study to report normative values for Mandarin-English speakers using the Nasometer II. Values reported can be used for objective assessment of bilingual speakers.

POSTERIOR PHARYNGEAL WALL AUGMENTATION WITH MUSCULAR FLAP VERSUS MUSCULOMUCOSAL FLAP FOR CORRECTION OF VELOPHARYNGEAL INCOMPETENCE

This study was aimed to evaluate and compare the posterior pharyngeal wall augmentation using muscular flap versus musculomucosal flap for correction of velopharyngeal incompetence (VPI). Patients and methods: this study was conducted on twenty children (13 males and 7females) complaining from VPI with age ranging between 6.5 and 13 years with a mean of age 8.7 years. All patients were treated surgically using posterior pharyngeal wall augmentation. Patients were classified into two equal groups according to the type of flap technique used for posterior pharyngeal wall augmentation. Group I included10 patients (7 males and 3 females) were treated by muscular flap. Group II included10 patients (6 males and 4 females) were treated by musculomucosal flap. The preoperative and postoperative assessments for patients with VPI included clinical examination of the voice, nasopharyngoscopy and computed tomography (CT) scans. Results: Regarding clinical presentation (hypernasality and nasal regurgitation of fluid), all patients in both groups had no nasal regurgitation of fluid or food which represents 100%. As regard the overall nasalance results (Nasal sentence) measured by nasometry in both groups there was noticeable improvement. But when comparing overall nasalance results between both groups there was no significant difference .Competence and borderline closure was achieved in 65% for patients of both groups. The VP gap size reduction was achieved in both groups, however there was no significant difference regarding reduction of median VP gap size. Conclusion: At the end, as there no significant difference in the results of both groups: the myomucosal flap technique for posterior pharyngeal wall augmentation is simple and easier than the muscular flap technique and the posterior pharyngeal wall augmentation is a good technique for treatment of VPI

Dialectal and gender differences in nasalance for a Mandarin population

ABSTRACTThe purpose of this study was to determine whether there are dialectal and gender related differences in nasalance of main Mandarin vowels and three sentences in 400 Chinese normal adults. The mean nasalance score difference for dialect and gender was significant (p < .001) in all speech materials. For different dialects, the average nasalance scores show that Chongqing > Beijing > Shanghai > Guangzhou for the nasal sentence, oro-nasal sentence, /a/, /i/ and /u/. In addition, the average nasalance scores of females were higher than those of males for all speech materials in all dialects. The clinical significance of this study can be helpful in making nasalance clinical decisions for Chinese people with cleft palate, hearing disorders and dysarthria with resonance disorders. It also shows the theoretical and socio-cultural features for linguists considering dialects and gender.

Impact of Nasal Surgery on Speech Resonance

The nose and paranasal sinuses contribute to speech resonance and changes to these structures may alter speech nasality. This change may influence one's vocational and social functioning and quality of life. Our investigation explored objective and subjective changes in nasality following nasal surgery in a prospective and longitudinal fashion. Recordings of sustained vowel and sentence stimuli and voice-related quality of life measurements were obtained preoperatively and at 2, 4, 8, and 24 weeks postoperatively from individuals undergoing nasal and/or sinus surgery. Objective measures of fundamental frequency, jitter, shimmer, and harmonic to noise ratio (HNR) were determined. Pre- and postoperative speech samples were assessed by 15 naïve listeners. In all, 15 subjects completed the study. Neither speakers nor listeners perceived a subjective change in nasality following surgery. No statistically significant change in microacoustic measures were identified. Although nasal sentences did not reveal differences for 3 microacoustic measures, a difference in HNR was identified. Patients undergoing nasal surgery did not exhibit subjective changes in resonance postoperatively. Aside from a difference in HNR for the nasal sentence, objective microacoustics remained unchanged. These results demonstrate the stability of oranasal resonance despite nasal surgery and provide valuable data for patient informed decision-making.

Effects of sinus surgery on speech

Objectives: (1) To assess the speech of the patients before and after functional endoscopic surgery (FES), and (2) to estimate the role of paranasal sinuses in the nasal tone of speech. Methods: A prospective controlled study done on 30 patients and 10 controls in 2 tertiary medical centers. The patients were suffering from nasal obstruction due to chronic sinusitis. They were subjected to questionnaire with 10 point visual analogue scale, full history, clinical examination by CT scan to paranasal sinuses in addition to subjective assessment. They were also assessed objectively by acoustic analysis of nasalized and nonnasalized speech samples using nasometer and aerodynamic studies using the Results: Objective improvement of the nasal obstruction after surgery by measuring of the mean nasal sentence percentage by nasometer more with patients with severe pathology. -Objective improvement of the nasal flow ,nasal pressure and by dividing nasal sound pressure level /oral sound pressure level measured by (PERCI). There is high individual variation in the nasal resonance, nasal flow, and nasal sound pressure/oral sound pressure. Conclusions: (1) There is improvement of the degree of hyponasality of the patients to match the range of nasality of normal subjects. These changes are affected by the degree of the pathology and the type of the surgical procedure. Despite the fact that FES is a minimal surgical procedure, it may produce significant changes in nasality so we believe that we have to inform patients, especially professional voice users about the possible effects of FES on voice quality. (2) The participation of the nasal sinuses especially the ethmoids in the nasality of speech is negligible in contrast to the inferior turbinate that its partial resection greatly affect the speech nasality.

Nasalance measures in German-speaking cleft patients.

The purpose of this study was to evaluate nasalance measures in German-speaking patients with different types of repaired cleft lip and palate and to find out if significant nasalance gender differences exist in the different cleft groups. A total of 125 German-speaking cleft patients (74 male and 51 female) were included in this study: 18 patients with isolated unilateral cleft lip (UCL; mean age: 13.00 +/- 2.03 years), 66 patients with complete unilateral cleft lip and palate (UCLP; mean age: 14.80 +/- 3.45 years), 25 patients with isolated cleft palate (CP; mean age: 14.60 +/- 3.48 years), and 16 patients with complete bilateral cleft lip and palate (BCLP; mean age: 14.30 +/- 3.61 years). Nasalance data were collected and computed using the NasalView hardware/software system (Fa. Tiger Electronics, Seattle, WA). Speech stimuli according to a modified Heidelberg Rhinophonia Assessment Form (sustained vowels "a," "e," "i," "o," and "u"; oral and nasal sentences; and three oral-nasal reading passages) were used to obtain nasalance scores. Nasalance distance and ratio were also calculated for the oral and nasal sentences and for one of the oral-nasal reading passages. Unpaired t tests showed no significant gender nasalance differences in each cleft group. Analysis of variance showed no significant differences in mean nasalance distance and ratio. For the nasal sentence, a significant difference (P = 0.032) in mean nasalance scores was found between the UCL and UCLP groups.

Nasalance distance and ratio: two new measures.

Mean nasalance in speakers with perceptually normal nasal resonance can differ in magnitude considerably. In addition, categorizations of speech based on nasalance scores may not agree with perceptual judgments. To overcome this limitation, we evaluated two new simple measures derived from mean nasalance data: the nasalance distance (range between maximum and minimum nasalance) and the nasalance ratio (minimum nasalance divided by maximum nasalance). Department of Oral and Maxillofacial Surgery, University of Technology, Munich, Germany. The sample consisted of 133 cleft lip and palate patients with normal nasal resonance or varying degrees of hypernasality. Oral and nasal acoustic measurements were made using the NasalView system. Nasalance distance and nasalance ratio were calculated for five non-nasal and three nasal sentences from the modified Heidelberg Rhinophonia Assessment Form. Optimum cutoffs were derived from receiver-operating characteristics. Results for the sentence stimuli ranged from 64.4% to 89.6% sensitivity and from 91.2% to 94.1% specificity. When the analysis was limited to only one nonnasal and one nasal sentence, results ranged from 79.7% to 87.5% sensitivity and from 88.2% to 97.1% specificity. We conclude that the two new measurements are valuable in routine clinical examinations. Nasalance distance and ratio derived from sentence stimuli are two useful and easily applicable measures that can be used to supplement the nasalance mean value.

Articulation and nasality changes resulting from sustained palatal fistula obturation.

The purpose of the study was to determine differences in articulation and nasality with obturation over time in children with a palatal fistula. Articulation and nasality were measured with the fistula open, immediately after obturation, and 4 to 7 weeks postobturation. SETTING, PATIENTS, PARTICIPANTS: Subjects were 15 patients with a palatal fistula secondary to a repaired cleft palate who were seen through the Orofacial Program, Utah Department of Health, ranging in age from 4 years 6 months to 13 years 1 month. Acrylic palatal obturators were designed to provide coverage specific to the unique shape and location of each child's fistula. Obturators were cemented to molar teeth using wire clasps for control of usage. Measurements consisted of listener judgments of hypernasality, hyponasality, and nasal emissions; instrumental ratings of nasalance using the Nasometer 6200-2; and performance on a standardized articulation test. Significant improvement occurred only on nasal emission measures from the preobturation condition to immediate postobturation. However, significant improvement was found in articulation, listener judgments of hypernasality, nasal emissions, and Nasometric Nasal Sentence mean scores from the preobturation condition to 4 to 7 weeks postobturation and from the immediate postobturation condition to 4 to 7 weeks postobturation. No significant differences were found between conditions for listener judgments of hyponasality and Nasometric Zoo and Rainbow Passage scores. Obturation of the palatal fistula over a 4- to 7-week period resulted in no adverse effect on articulation ability, perceptual ratings of nasality, or instrumental ratings of nasalance. Clinical management of patients with a palatal fistula can be enhanced with treatment using obturation over time. For subjects who continue to exhibit hypernasality immediately postobturation, sustained obturation is advocated prior to consideration of surgical intervention for treatment of a palatal fistula and/or velopharyngeal dysfunction.