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KMID : 0952820210240010042
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Journal of Korean Cleft Lip & Palate Association
2021 Volume.24 No. 1 p.42 ~ p.52
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The Objective Speech Evaluation after Pharyngeal Flap Surgery in Adult Patients with Velopharyngeal Insufficiency: A Case Report
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Park Jong-Hoon
Kim Da-Wa
Seok Hyun
Baek Jin-A
Ko Seung-O
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Abstract
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The purpose of this study is to objectively evaluate the post-surgical aerodynamic and acoustic characteristics of patients with velopharyngeal insufficiency (VPI) who received superiorly based pharyngeal flap surgery. Parameters for post-surgical evaluation of speech improvements vary by study designs, and the availability of objective research data is limited. VPI, also known as velopharyngeal Dysfunction (VPD), is a condition in which the soft palate and muscles of the posterior and lateral wall cannot form a velopharyngeal port. Objective evaluation of velopharyngeal closure is essential in the diagnosis and treatment of VPI. Hypernasality and limitations in speech articulation can be managed through various modalities, including speech therapy, speech-aid prosthetics, and surgical interventions. For patients with severe hypernasality, a superiorly based pharyngeal flap is the most commonly used procedure for the surgical correction of VPI. In this study, three patients (two male, one female) status post superiorly based pharyngeal flap surgery for hypernasality and inaccurate pronunciation were evaluated by a speech-language pathologist. Nasometers were used for objective measurement of post-surgical nasalance scores. The study results confirmed a significant and sustained improvement in nasality post superiorly based pharyngeal flap. Nasalance scores improved or reached normal limits during 1-2 months after surgical procedure, but with a tendency to relapse over time.
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KEYWORD
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VPD, VPI, Adults, Cleft palate, Pharyngoplasty, Posterior pharyngeal flap, Nasometer, Nasalance
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