Speech In Cleft Palate Patients Research Articles

구개열 환자 발음 판별을 위한 특징 추출 방법 분석

This paper presents an analysis of feature extraction methods used for distinguishing the speech of patients with cleft palates and people with normal palates. This research is a basic study on the development of a software system for automatic recognition and restoration of speech disorders, in pursuit of improving the welfare of speech disabled persons. Monosyllable voice data for experiments were collected for three groups: normal speech, cleft palate speech, and simulated clef palate speech. The data consists of 14 basic Korean consonants, 5 complex consonants, and 7 vowels. Feature extractions are performed using three well-known methods: LPC, MFCC, and PLP. The pattern recognition process is executed using the acoustic model GMM. From our experiments, we concluded that the MFCC method is generally the most effective way to identify speech distortions. These results may contribute to the automatic detection and correction of the distorted speech of cleft palate patients, along with the development of an identification tool for levels of speech distortion.

Speech evaluation and dental arch shape following pushback palatoplasty in cleft palate patients: Supraperiosteal flap technique versus mucoperiosteal flap technique

The aim of this study was to evaluate and compare the maxillary dental arch shape and speech of cleft palate patients following pushback palatoplasty using either the supraperiosteal flap technique or the mucoperiosteal flap technique. Sixty-two patients (29, cleft palate only; 33, unilateral cleft lip, alveolus and palate) operated on by the supraperiosteal technique and 47 patients (23, cleft palate only; 24 unilateral cleft lip, alveolus and palate) by the mucoperiosteal technique were reviewed in this study. Dental arch shape and speech proficiency at preschool and school age were evaluated in all patients. Dental arch shapes were classified as U type (good dental arch shape) and V type (narrow dental arch shape). In cleft palate only patients, U type was observed in 90% of the supraperiosteal group and 83% of the mucoperiosteal group. In unilateral cleft lip, alveolus and palate patients, U type was observed in 85% of the supraperiosteal group, while only in 33% of the mucoperiosteal group. In cleft palate only patients, normal speech at school age was observed 100% of the supraperiosteal group and 83% of the mucoperiosteal group. In unilateral cleft lip, alveolus and palate patients, normal speech at school age was observed in 97% of the supraperiosteal group and 75% of the mucoperiosteal group. Misarticulation was frequently found in patients with the V type of dental arch shape. It is suggested that pushback palatoplasty using the supraperiosteal technique is more advantageous for speech development compared with the mucoperiosteal technique.

Surgery for speech in cleft palate patients

Superiorly based pharyngeal flaps and sphincter pharyngoplasties are the two main possibilities for the surgical treatment of hypernasality in velopharyngeal dysfunction. Videonaspharyngoscopy and multi-view videofluoroscopy can provide anatomical and physiological data for planning these surgical procedures for correcting hypernasality. This study was undertaken to assess the planning and outcome of pharyngeal flaps and sphincter pharyngoplasties for correcting velopharyngeal insufficiency. The surgical techniques were customized according to the findings of videonasopharyngoscopy and multiview videofluoroscopy. Seventy patients with repaired palate clefts and residual velopharyngeal dysfunction were studied. The patients were randomly divided into two groups. The first group received a pharyngeal flap. The second group received a sphincter pharyngoplasty. Both procedures were individually customized according to the findings of videonasopharyngoscopy and multi-view videofluoroscopy. There was a non-significant difference (P >0.05) between the mean size of preoperative velopharyngeal closure gap between the two groups of patients (mean=27.5%; S.D.=7.7% versus mean=28.3%; S.D.=5.9%). Postoperatively, velopharyngeal dysfunction was completely corrected in 89% of the cases from group 1, and in 85% of the cases from group 2. There was a non-significant difference (P >0.05) between the success rate for correcting VPI in both groups of patients. Pharyngeal flap and sphincter pharyngoplasty seem to be safe and reliable procedures for treating residual velopharyngeal dysfunction. Although not all the patients studied for this paper achieved complete closure after the surgical procedures, all of them showed a reduction of the size of the velopharyngeal closure defect. The planning of the surgical procedure, in order to match the postoperative structure to the preoperative velopharyngeal dimensions and movements visualized through Videonasopharyngoscopy and videofluoroscopy, seems to be the most important aspect of the surgery for correcting residual velopharyngeal dysfunction.

The Influence of Cephalometric Parameters on Resonance of Speech in Cleft Lip and Palate Patients An Interdisciplinary Study

There are only few studies concerning the correlation between craniofacial morphology and resonance of speech in cleft palate patients. Moreover, these investigations show a considerable inhomogeneity in material and method, their basic approach was predominantly retrospective, and the statistical methods were restricted to univariate procedures. Thus, the aim of the present study was twofold: firstly to clarify the extent to which correlations exist between craniofacial morphology and resonance of speech in cleft palate patients, subject to a sufficiently large number of patients being available to ensure differentiation with regard to age and cleft type, and secondly, within a prospective longitudinal study in juvenile cleft palate patients, to investigate whether pubertal craniofacial growth changes result in changes of resonance. The collective comprised 137 cleft palate patients. The following investigations were performed: lateral cephalometry, nasometry, and standardized speech recording. Additionally, these investigations were repeated in 51 juvenile patients after a minimum time interval of 2 years. In order to analyze the complex relations between craniofacial morphology and degree of hypernasality, multivariate statistical procedures were applied. The results of the present study indicate complex correlations between cephalometric parameters and resonance of speech, requiring age-specific differentiation. In this regard, the ratios between the length of the soft palate and the sagittal depth of the nasopharyngeal airway were of prime importance. Beyond this, significant correlations were found between craniofacial growth changes and changes of resonance during puberty which might be influenced both by dentofacial orthopedics and by maxillofacial surgery.

Videonasopharyngoscopy as an instrument for visual biofeedback during speech in cleft palate patients

Videonasopharyngoscopy was used as an instrument for visual biofeedback during speech in cleft palate patients. Seventeen cleft palate patients were randomly selected for the study. All patients showed velopharyngeal insufficiency (VPI), compensatory articulation (CA) and negative movement of lateral pharyngeal walls (NMLPW) during speech. Nine patients received speech therapy for correcting CA. Eight patients received speech therapy and underwent videonasopharyngoscopy as an instrument for visual biofeedback of the velopharyngeal sphincter. After 12 weeks, NMLPW was modified in the patients receiving speech therapy and visual biofeedback. In contrast, NMLPW was still present in eight out of nine patients receiving only speech therapy. These patients received visual biofeedback and NMLPW was corrected in all cases. After six months, all 17 patients had corrected CA during isolated speech. All patients received a tailor-made pharyngeal flap. VPI was completely corrected in 15 cases. In the two cases in which VPI was still present postoperatively, the size of the defect at the velopharyngeal sphincter had been significantly reduced. In these two patients, visual biofeedback was used postoperatively for increasing lateral pharyngeal walls (LPW) motion towards the borders of the flap. After 18 months since the onset of speech therapy all the patients had normal nasal resonance and normal articulation during connected speech.

The evaluation of speech in cleft palate patients in our clinic: The efficacy of the hotz plate for the improvement of speech

The evaluation of speech in cleft palate patients in our clinic: The efficacy of the hotz plate for the improvement of speech

The physiologic basis for hypernasality during connected speech in cleft palate patients: A nasendoscopic study: P. E. Osberg and M. A. Witzel. Plast Reconstr Surg 67:1–5, (January), 1981

The physiologic basis for hypernasality during connected speech in cleft palate patients: A nasendoscopic study: P. E. Osberg and M. A. Witzel. Plast Reconstr Surg 67:1–5, (January), 1981

The physiologic basis for hypernasality during connected speech in cleft palate patients: a nasendoscopic study.

A characteristic pattern of velopharyngeal movement is associated with hypernasality. Nasendoscopic examination can identify the patterns of movement of the velopharynx during connected speech. The nasendoscopic observations provide a safe, objective way of assessing the anatomic dysfunction that causes hypernasality. These observations provide a clearer rationale for the design and placement of pharyngoplasty surgery. Recognition of distinct dysfunctional patterns opens the door to nonsurgical correction of hypernaslity in selected patients using the nasendoscope and video display.

Air flow and intelligibility of speech of normal speakers and speakers with a prosthodontically repaired cleft palate

In recent years there has been an increase in the use of physiologic tests for the analysis of air flow and pressure required for speech production. Qualitative and quantitative evaluations of these aspects have been made in subjects with normal and defective speech. 1-4 Various methods have been used to determine velopharyngeal function. The techniques that have been used in diagnosis and management have included radiography, air flow and pressure measurements, and use of the trained ear of the speech pathologist. In 1965 Skoog 5 stated that conclusions concerning the velopharyngeal system were even then based on inadequate information. This may have been due to a lack of means for objective study of the structures involved with the velopharyngeal mechanism during connected speech. Objective records using respirometric techniques for air flow and pressure measurements have been used and correlated with listener perception of speech intelligibility. A phenomenon termed hypernasality, generally exhibited in the speech of cleft-palate patients, may contribute to listeners' judgments of unintelligible speech. It cannot be assumed, however, that hypernasality is either the greatest or the sole contributor to reduced intelligibility. As Moll 6 reported, ... speech dimensions must be defined ultimately in terms of listener perception, nasal voice quality is defined best as a perceptual dimension. The fact that air may be inappropriately directed into the nasal cavity with or without a judgment of hypernasality could contribute to listener perception of unintelligible speech. Inappropriate air direction, resulting from velar insufficiency, may establish the relationship between ~ *Associate Professor. Communication Disorders Program. **Associate Professor, Speech and Hearing Clinic. air flow and perception of intelligibility, an important factor in the speech process. By establishing the relationship between air flow and perception of intelligibility, a check-and-balance system can be developed to provide more comprehensive rehabilitation for cleft-palate speakers. This study was designed to assess the relationship between air flow and listeners' identification of certain fricatives in selected words for normal and cleft-palate speakers. METHOD

Hearing and nasal function correlated to postoperative speech in cleft palate patients with velopharyngoplasty.

82 patients with cleft palates and who had undergone velopharyngo-plasty were examined one year after operation. The findings of aural pathology, hearing and nasal function were correlated to the postoperative speech evaluation. The incidence of aural pathology was 78 per cent. Despite the very high figure for aural pathology only 13 per cent of the patients had hearing losses of such a degree (30 dB or more) that it might influence the postoperative speech rehabilitation. Only 47.7 per cent of the patients had a good nasal function postoperatively. A correlation was found between the postoperative speech result regarding both hearing loss and nasal function, more marked for nasal function. Asymmetries in the nasal cavities were found to be responsible for postoperative asymmetries in the passages lateral to the velopharyngeal flap. It is evident that nasal function is just as important a factor as hearing for a good postoperative speech rehabilitation.82 Gaumenspalten-Patienten mit einer Velum-Pharynx-Pl...

Observations on the pharyngeal flap operation for the improvement of speech in cleft palate patients.

Observations on the pharyngeal flap operation for the improvement of speech in cleft palate patients.