CPAP--NEW THERAPY FOR HYPERNASAL SPEECH

这个项目的目的是评估一种新的治疗方法。 用来治疗上鼻音。过度鼻音常常伴随着唇裂 味觉、神经运动障碍和其他损伤。这是一种常见的 沟通障碍在头面部和言语诊所治疗。 尽管已经做出了许多尝试来减少过度鼻音 在治疗方面，它一直拒绝单独使用治疗来改变。 治疗中重度上鼻息肉的首选治疗方案 是手术，尤其是咽皮瓣。然而，这种手术需要 全身麻醉，并可能导致术后张口呼吸 很复杂。 建议的治疗方法包括一种已经被用来 治疗睡眠呼吸暂停患者，持续气道正压通气(CPAP)。 由机动管面罩组件提供给鼻腔的压力 通道有助于在睡眠期间保持呼吸道通畅。虽然不是 原本打算在演讲中使用的压力传递到 鼻道提供了对腭咽闭合的阻力，这可能 纳入有原则的抵抗力训练方案 运动生理学中常用来增强肌肉的。 五名表现为中度鼻音亢进的受试者将接受 在为期八周的家庭计划中进行治疗，每周六次。这个 由CPAP装置提供的鼻压和用于每个鼻压的时间 会议将在八周内逐步递增 程序。初始压力将为每个受试者量身定做。一个 将采用多探针单主题研究设计， 受试者将充当自己的控制者。使用的因变量 评估鼻腔过长的潜在变化将包括 工具测量，纳氏计值，和感知测量， 听众的判断。 与以前的方法相比，建议的疗法有几个优点： 1)腭咽闭合机制在语音产生过程中被操控 与吞咽和吹气等非言语任务相反，2) 正压加载腭咽闭合机构，从而利用 在抗力训练中，3)逆行压力锋与 语音过程中的呼吸压力前沿，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) 仪器设备使用方便，而且治疗可以在 回家，从而能够频繁和方便地进行治疗。

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.