摘要
目的探讨腭裂术后语音障碍患者声门塞音对鼻音计评价腭咽闭合状态的影响。方法纳入2004年8月至2010年8月北京大学口腔医学院·口腔医院口腔颌面外科收治的71例腭裂术后语音障碍患者,腭裂代偿语音评价为伴或不伴声门塞音,男性50例,女性21例,年龄(15.9±6.2)岁。应用鼻音计和鼻咽纤维内镜同步检查,记录所有患者鼻音计鼻音化率值和鼻咽纤维内镜视觉模拟量表(visual analog scale,VAS)分值数据,并根据声门塞音语音评价结果将患者分成3组,即整体组(未排除声门塞音)、声门塞音组及无声门塞音组,对3组患者的11个语音样本(单元音1~3号、连续音节4~9号、语句10~11号)鼻音化率值与VAS值进行Pearson相关分析。结果整体组患者71例,声门塞音组患者34例,无声门塞音组37例。整体组患者的11个语音样本鼻音化率值与VAS值间均呈负相关趋势,但均无显著的相关关系(r>-0.179且<-0.017,P>0.05);声门塞音组各语音样本鼻音化率值与VAS值之间均无显著的相关关系(r>-0.196且<-0.017,P>0.05);无声门塞音组除1、3、11号语音样本外,其余各语音样本鼻音化率值与VAS值均呈显著负相关关系(r>-0.557且<-0.162,P<0.05),其中7号语音样本最敏感(r=-0.557,P<0.05)。结论声门塞音是影响鼻音计评价腭咽闭合功能的重要因素,对于存在声门塞音的腭裂语音障碍患者不建议应用鼻音计进行腭咽闭合功能评价,但可以指导语音训练。
Objective To investigate the influence of glottal stops for the relationship between nasalance and velopharyngeal closure status of cleft palate patients after surgery.Methods A total of 71 patients with postoperative cleft palate speech disorders treated in the Department of Oral and Maxillofacial surgery,School of Stomatology,Peking University from August 2004 to August 2010 were included.The compensated speech evaluation of cleft palate with or without glottic occlusion was performed in 50 males and 21 females with an average age of(15.9±6.2)years old.The nasal sound meter and nasopharyngeal fiber endoscope were used to record the nasal phonation rate and the score of nasopharyngeal fiber endoscopic visual analog scale(VAS)of the patients.According to the results of glottic plug speech evaluation,the patients were divided into three groups:whole group(without glottic plug),glottic plug group and silent glottic plug group.The nasal phonation rate values and VAS values of 11 speech samples(unit vowel No.1-3,continuous syllable No.4-9,sentence 10-11)of the three groups were compared by Pearson analysis.Results There were 71 patients in the whole group,34 patients in the glottic plug group and 37 patients in the silent glottis group.There was a negative correlation between nasal phonetic rate and VAS of 11 speech samples in the whole group,however there were no significant difference(r>-0.179 and<-0.017,P>0.017)and no significant correlation between nasal phonetic rate and VAS in glottic occlusion group(r>-0.196 and<-0.017,P>0.05).There was a significant negative correlation between nasal phonetic rate and VAS value of all but No.1,3 and 11 speech samples in silent door plug group(P<0.05),among which No.7 speech sample was the most sensitive sample(r=-0.557,P<0.05).Conclusions The present study showed the glottal stops could affect the evaluation of the velopharyngeal closure function by using nasometer.Glottal stops should be considered as one important factor for the nasalance.
作者
高涛
马莲
罗奕
孙勇刚
Gao Tao;Ma Lian;Luo Yi;Sun Yonggang(Department of Dentistry,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Oral and Maxillofacial Surgery,Peking University School and Hospital of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China)
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2020年第12期958-962,共5页
Chinese Journal of Stomatology
关键词
腭裂
腭咽闭合不全
声门塞音
Cleft palate
Velopharyngeal insufficiency
Glottal stops
