New strategy to improve velopharyngeal incompetence using CPAP and speech appliances.

1.在包括腭提升和讲话的语音矫治器的放置条件下，球，腭帆提肌（LVP）的活动在讲话和吹气的条件下均降低。LVP在放置和移除语音矫治器之间的差异性活动可能会产生语音功能的储备能力。正常情况下，通过放置语音矫治器可以改变腭咽功能。因此，持续正压治疗可改善说话者的咽喉功能3。与严重的喉咽功能不全和边缘性喉咽功能不全的说话者一样有效. CPAP对佩戴语音矫治器、PLP或语音灯泡的说话者的临床应用结果表明，CPAP的功效可能取决于语音矫治器对咽部的适应性。也就是说，在语音矫治器适应不良的情况下，CPAP对改善患者咽功能的作用不如语音矫治器适应良好的情况明显。未来的研究应保证澄清一个良好的适应性的语音矫治器的情况下，咽喉通常可以有效地改善实质性的咽喉功能不全。

1. In the placement condition of a speech appliance including a palatal lift and speech, bulb, levator veli palatini muscle (LVP) activity decreased in both condition of speech and blowing. The differential activity in LVP between placement and removal of a speech appliance might generate reserve capacity for velopharyngeal function for speech.2. Velopharyngeal function might be normally altered through placement of a speech appliance. Thus, continuous positive air pressure treatment for improvement of velopharyngeal function for speakers3. with substantial velopharyngeal incompetence could be effective as well as speakers with borderline velopharyngeal incompetence.4. The results of clinical application of CPAP for speakers wearing a speech appliance, a PLP or a speech bulb, showed that the efficacy for the CPAP is possible to dependent upon adaptation of a speech appliance to velopharyngeal. That is, in case of poor adapted speech appliance, the effect of CPAP to improve velopharyngeal function was not so clear as in case of a well adapted one.5. Future study should be warranted to clarify whether a well adapted speech appliance in relation to the circumstance of the velopharynx can commonly be effective to improve substantial velopharyngeal incompetence.