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Development of Therapeutic Procedure to Stimulate Velopharyngeal Function using Newly Designed Speech Appliance.

使用新设计的言语器具刺激腭咽功能的治疗程序的开发。

基本信息

批准号：
05807187
负责人：
TACHIMURA Takashi
金额：
$ 1.15万
依托单位：
OSAKA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1993
资助国家：
日本
起止时间：
1993 至 1994
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05807187/
关键词：
SPEECH APPLIANCE LEVATOR VELI PALATINI MUSCLE ORAL AIR PRESSURE NASAL AIR PRESSURE CLEFT PALATE VELOPHARYNGEAL INCOMPETENCE BULB REDUCTION SPEECH FUNCTION バルブ削除療法

项目摘要

The purpose of this study is to establish a strategy to stimulate velopharyngeal function using speech bulb reduction. To determine an adequate reduction volume of the bulb, levator muscle activity associated with changes in nasal air flow rate and oral air pressure was monitored when respiratory air was allowed into the nasal cavity through the opening drilled in the vertical center of the bulb of a speech appliance. The opening area was varied from 0 (occluded condition) to 38.5mm^2 through 12.6mm^2. Multiple regression analyzes showed that levator muscle activity correlated with nasal air flow rate and oral air pressure, while nasal air flow rate contributed to the changes in levator muscle activity more significantly than oral air pressure did. Based on the results, prototype strategy of bulb reduction therapy was designed and applied to 5 repaired cleft palate patients who were routinely wearing a speech appliance. That is, bulb reduction was performed so that decrease in the bulb volume could be equal to the circular area ranged from 12.6mm^2 to 38.5mm^2 in horizontal projection. The reduction was carried out monthly for 3 months. Nasopharyngeal fiberscopic and perceptual evaluations were carried out onemonth after each reduction. As results, four out of five subjects showed complete closure of the velopharynx and no nasal emission during obstruent speech, and the improved veloharyngeal function was observed in each evaluation. However, another subject showed complete closure in first and second evaluation, while third evaluation did not show any improvement. The results suggested that this prototype of bulb reduction strategy might be effective for the improvement of velopharyngeal function, while the process towards improved velopharyngeal function might be variable across subjects. A maintenance of the reduction effect warrants future study.

这项研究的目的是建立一种策略，通过减少语球来刺激腭咽闭合功能。为了确定适当的缩小量，当呼吸空气通过语音矫治器的垂直中心的开口进入鼻腔时，监测了与鼻气流量和口腔气压变化相关的提肌活动。开放面积从0(闭塞状态)到38.5 mm~12.6 mm 2。多元回归分析显示，提上肌肌活动与鼻气流量和口腔气压相关，鼻气流量比口腔气压对提肌活动的贡献更大。在此基础上，设计了缩球治疗的原型策略，并应用于5例常规佩戴语音矫治器的腭裂修复术患者。也就是说，进行球囊缩小，使球囊体积的减少等于水平投影中12.6 mm^2到38.5 mm^2的圆形面积。每月一次，连续3个月。在每次复位后一个月进行鼻咽镜检查和感觉评估。结果，5名受试者中有4名显示腭咽完全闭合，在说话障碍时没有鼻音流出，并且在每次评估中都观察到了速度咽功能的改善。然而，另一科目在第一次和第二次评价中表现出完全封闭，而第三次评价没有任何改善。结果表明，这种缩小球策略的原型可能对改善腭咽闭合功能有效，而改善腭咽闭合功能的过程可能因受试者而异。维持减排效果值得进一步研究。