CPAP--NEW THERAPY FOR HYPERNASAL SPEECH

该项目的目的是评估一种新的治疗方法 用于治疗鼻音过多的言语。 鼻窦炎常常伴随着唇裂 上颚、神经运动障碍和其他障碍。 这是一个常见的 颅面和言语诊所治疗的沟通障碍。 尽管已经做出了许多尝试来减少鼻音过多 在治疗上，它一直难以单独使用治疗来改变。 中度至重度鼻过多症的首选治疗方法通常是 是手术，尤其是咽瓣。 然而这样的手术需要 全身麻醉，并可能导致术后用口呼吸 并发症。 拟议的疗法涉及一种已用于 治疗睡眠呼吸暂停患者，持续气道正压通气（CPAP）。 由电机-管-面罩组件传送至鼻腔的压力 通道有助于在睡眠期间保持呼吸道通畅。 虽然不是 最初打算在演讲期间使用，压力传递到 鼻腔对腭咽闭合产生阻力，可以 纳入有原则的阻力训练方案中 常用于运动生理学中以增强肌肉。 五名表现出中度鼻音过多的受试者将接受 为期八周的家庭治疗计划，每周六次。 的 CPAP 设备提供的鼻压以及每个呼吸所需的时间 课程将在八周内逐步增加 程序。 初始压力将为每个受试者量身定制。 一个 将使用多探针单受试者研究设计，并且 受试者将作为自己的对照。 使用的因变量 评估鼻音过多的潜在变化将包括 仪器测量、Nasometer 值和感知测量， 听者的判断。 与以前的方法相比，所提出的疗法有几个优点： 1）在言语产生过程中操纵腭咽机制 与吞咽和吹气等非言语任务相反，2） 正压加载腭咽机构，从而利用 阻力训练，3）逆行压力前沿反对 说话时的呼吸压力前沿，从而直接影响 可能的言语调节参数，4) 该方法是非侵入性的，5) 6)仪器装置使用方便，可在室内进行治疗。 在家中，从而可以进行频繁且方便的治疗。

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.