CPAP--NEW THERAPY FOR HYPERNASAL SPEECH

本项目的目的是评估一种新的治疗方法 用于治疗鼻音过重 高鼻音常伴唇裂 腭、神经运动障碍和其他损伤。 它是一种常见 在颅面和语言诊所治疗的交流障碍。 尽管已经进行了许多尝试来减少鼻音过浓 在治疗上，它已经抵抗单独使用治疗的改变。 中重度鼻音过浓的治疗选择通常 是外科手术，尤其是咽部皮瓣。 然而，这种手术需要 全身麻醉，并可能导致口呼吸作为手术后 并发症 所提出的疗法涉及一种方法， 治疗睡眠呼吸暂停患者，持续气道正压通气（CPAP）。 由马达-管-面罩组件输送到鼻腔的压力 呼吸道有助于在睡眠期间保持气道通畅。 尽管未 最初打算在讲话过程中使用，压力传递到 鼻通道提供了对咽喉闭合的阻力， 纳入阻力训练方案， 通常用于运动生理学以增强肌肉。 表现出中度鼻音过浓的五名受试者将接受 在一个为期八周的家庭治疗计划，每周六次会议。 的 由CPAP装置输送的鼻压和用于每个的时间 会话将在八周内以逐步方式递增 程序. 初始压力将针对每个受试者量身定制。 一 将采用多探头单受试者研究设计， 受试者将作为自己的对照。 使用的因变量 评估鼻音过强的潜在变化将包括 仪器测量、Nasometer值和感知测量， 听众的判断 与以前的方法相比，所提出的疗法具有几个优点： 1)在语音产生期间， 与吞咽和吹气等非言语任务相反，2） 正压加载咽部机制， 阻力训练，3）一个逆行的压力前线反对 在讲话期间的呼吸压力前沿，从而直接影响 可能的语音调节参数，4）该方法是非侵入性的，5） 仪器装置易于使用，6）治疗可以在 从而能够进行频繁和方便的治疗。

The purpose of this project is to evaluate a new therapy approach for treating hypernasal speech. Hypernasality often accompanies cleft palate, neuromotor disorders, and other impairments. It is a common communication disorder dealt with in craniofacial and speech clinics. Although many attempts have been made to reduce hypernasality therapeutically, it has been resistant to change using therapy alone. The treatment of choice for moderate-to-severe hypernasality typically is surgery, especially pharyngeal flap. Yet such surgery requires general anesthesia, and may result in mouth breathing as a postsurgical complication. The proposed therapy involves an approach that has been used to treat sleep apnea patients, continuous positive airway pressure (CPAP). The pressure delivered by a motor-tube-mask assembly to the nasal passages helps to keep the airway patent during sleep. Although not originally intended to be used during speech, the pressure delivered to the nasal passages offers a resistance to velopharyngeal closure that can be incorporated in a regimen of resistance training with principles commonly used in exercise physiology to strengthen muscles. Five subjects exhibiting moderate hypernasality will receive the therapy in an eight-week home program with six sessions per week. The nasal pressure delivered by the CPAP device and the time devoted to each session will be incremented in a stepwise fashion across the eight-week program. The initial pressure will be tailored for each subject. A multiple-probe single-subject research design will be used and the subjects will serve as their own controls. The dependent variables used to assess potential changes in hypernasality will consist of an instrumental measure, Nasometer values, and a perceptual measure, listener judgments. The proposed therapy has several advantages over previous methods: 1) the velopharyngeal mechanism is manipulated during speech production as opposed to nonspeech tasks such as swallowing and blowing, 2) the positive pressure loads the velopharyngeal mechanism thereby making use of resistance training, 3) a retrograde pressure front opposes the respiratory pressure front during speech thereby directly influencing a likely speech regulatory parameter, 4) the method is noninvasive, 5) the instrument device is easy to use, and 6) therapy can be conducted in the home thereby enabling frequent and convenient therapy sessions.