• Title/Summary/Keyword: 구개인두부전

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A Case of Sphincter Pharyngoplasty for Persistent Velopharyngeal Insufficiency After Submucosal Cleft Palate Surgery (점막하구개열 수술 후 지속된 구개인두부전에 대한 수축근 구개인두성형술 증례)

  • Yunhyung, Lee;Yeon Soo, Choi ;Sungryeal, Kim;Jeong-Seok, Choi
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.3
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    • pp.188-192
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    • 2022
  • Velopharyngeal insufficiency (VPI) is a phenomenon that can occur due to anatomical or neurological causes of the soft palate. VPI can make the patient difficult to articulate through hypernasality and nasal emission. There has been needed the customized treatment, as VPI can occur for many causes. We present the case of 21-year-old male who took palate plastic surgery 20 years ago for congenital submucosal cleft palate. As he had poor contraction of both lateral side of velopharynx, he was diagnosed with coronal type VPI. Through sphincter pharyngoplasty, he can obtain improvement of articulation accuracy. We would like to share this challenged case.

A Case of Amyotrophic Lateral Sclerosis with Unilateral Vocal Fold Palsy and Velopharyngeal Insufficiency (일측성 성대마비와 구개인두부전을 초기 증상으로 내원한 Amyotrophic Lateral Sclerosis 1 예)

  • 박경호;김동현;조승호;김형태
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.1
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    • pp.51-53
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    • 2003
  • Amyotrophic lateral sclerosis Is an unusual pattern of distal muscular atrophy with permanent bulbar sign. Vocal fold paralysis and velopharyngeal insufficiency(VPI) due to soft palate paralysis Is occasionally associated with distal muscular atrophy. Recently we experienced a case of amyotrophic lateral sclerosis whose symptom was initially expressed with hoarseness and VPI. So we report a case with review of literature.

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Fabrication of palatal lift prosthesis using thermoplastic resin for a patient with velopharyngeal insufficiency (구개인두부전증 환자에서 열가소성레진을 이용해 연구개거상장치를 제작한 증례)

  • Jung, Hyun Jung;Kim, Jee Hwan;Lee, Sang-Hwy;Park, Young-Bum
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.286-290
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    • 2016
  • Recently, flexible removable prosthesis with thermoplastic resin clasp has increasingly become popular. In comparison with conventionally used acrylic resin, thermoplastic resin has lower flexural strength and elastic modulus. Thus, flexible removable prosthesis has low risk of fracture, so denture base can be made thin and light, increasing patient comfort. Also, it can passively sit at tooth undercut during rest, so abutment teeth need minimum or no preparation. In this case report, a 44 year old female patient with mild velopharyngeal insufficiency was treated with a palatal lift prosthesis made of polyester thermoplastic resin. Since the patient had no missing tooth and desired conservative treatment, the flexible removable prosthesis provided relatively satisfactory results.

Case Report: Repair of Complete Bilateral Cleft Palate Using Two-Flap Palatoplasty with Intravelar Veloplasty and Vomer Flap (연구개내근성형술 및 서골피판을 동반한 2개 점막성골막판을 이용한 완전 양측성 구개열 환자의 치험례)

  • Lee, Ui-Lyong;Seo, Byong-Moo;Choung, Pil-Hoon
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.1
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    • pp.33-40
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    • 2009
  • 구개열이 있으면 언어장애 음식섭취의 어려움, 구개범장근의 기능장애로 인한 이관의 개폐기능부전으로 중이의 액체고임, 부정교합등 여러 문제가 생길 수 있다. 따라서 구개성형술은 갈라진 경구개와 연구개를 막아주며 동적인 연구개를 만들어 주어 충분한 구개인두폐쇄를 하여 정상적 발음을 하는데 그 목표가 있다. 그 외에도 음식물을 정상적으로 섭취할 수 있고 중이염 및 난청을 일으킬 수 있는 기능을 개선시키고 정상적인 교합을 만들어주는데 있다. 위의 목표를 이루기 위해 지금까지 많은 수술 방법이 개발되었고 개선되어 왔다. 하지만 아직도 가장 효과적인 수술방법, 수술시기에 대하여 논쟁거리가 되고있다. 언어를 분명하게 하려면 연구개는 인두벽에 닿기 위해 후상방으로 올라가고 인두의 후벽과 측벽은 올라온 연구개에 닿으려고 수축함으로써 비인두와 구인두 사이의 공간이 좁아지게 됨으로써 가능하다. 따라서 발음이 정확하려면 비인두괄약(nasopharyngeal sphincter)을 합리적으로 만들어주어 비인두와 구인두를 분리해 주어야 한다. 비인두괄약을 조성해 주는 방법에는 구개범거근이 괄약기능을 할수 있도록 연구개내근성형술(intravelar veloplasty)을 시행하여 양편구개범거근을 횡위로 옮겨 연결하여 올림근 걸이(levator muscle sling)을 만드는 방법, 구개 연조직을 후방으로 밀어 구개 길이를 연장하는 방법, 인두 피판술을 하는 방법등이 있다. 구개범거근의 주행방향과 부착이 잘못되어 있는 것으로, 정상에서는 구개범거근이 횡으로 주행하여 연구개의 정중봉선(median raphe)에 부착하는 데 반해 구개열에서는 구개범거근이 전방으로 주행하여 개열 가까이에 있는 구개열 후연과 골선 개열연에 부착되어 있고 구개인두근과 구개수근이 연구개를 그냥 지나쳐직접 구개열 후연에 붙는다. 저자등은 완전 양측성 구개열을 연구개내근성형술 및 서골피판을 동반한 2개 점막성골막판을 이용한 구개성형술로 수술을 시행하여 다소의 지견을 얻었기에 문헌고찰과 함께 보고하는 바이다

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LONG TERM FOLLOW UP OF EFFECTIVENESS AND COMPLICATIONS OF PALATOPHARYNGOPLASTY (구개인두성형술의 효과 및 합병증에 관한 장기추적관찰)

  • 박재훈;이용배;남순열;김원일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.100-100
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    • 1993
  • Palatopharyngoplasty has been widely performed for the treatment of chronic snoring and obstructive sleep apnea syndrome. Lack of literature for long term effectiveness and complications of palatopharyngoplasty made us to report our result with minimum follow up of 5 years, compare to preop and postop 8 weeks deta. We evaluated subjective symptom and objectively documented polysomnographic improvement of 25 among 37 patients undergoing palatopharyngoplasty from 1987 to 1985. The remaining 12 patients were lost to follow up (1) snoring was abolized in 10 patients(40%) of these 25 patients and with vary degree(Grade 1-3), reduced in remainders except 3 patients (2) Sleep apnea seen preoperatively in 15 patient (AI > 20) was reduced to Grade 0 or Grade 1 in 13 patients. And marked change in AI & body weight was not seen at 5 year after operation. (3) 3 cases of mild velopharyngeal insufficiency, 1 case of asymmetry of soft palate 5 cases of pharyngeal dryness, were observed in this retrospective study and there was no nasopharyngeal stenosis loss of taste respiratory and cardiovascular complications.

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Analysis on Vowel and Consonant Sounds of Patent's Speech with Velopharyngeal Insufficiency (VPI) and Simulated Speech (구개인두부전증 환자와 모의 음성의 모음과 자음 분석)

  • Sung, Mee Young;Kim, Heejin;Kwon, Tack-Kyun;Sung, Myung-Whun;Kim, Wooil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.18 no.7
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    • pp.1740-1748
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    • 2014
  • This paper focuses on listening test and acoustic analysis of patients' speech with velopharyngeal insufficiency (VPI) and normal speakers' simulation speech. In this research, a set consisting of 50-words, vowels and single syllables is determined for speech database construction. A web-based listening evaluation system is developed for a convenient/automated evaluation procedure. The analysis results show the trend of incorrect recognition for VPI speech and the one for simulation speech are similar. Such similarity is also confirmed by comparing the formant locations of vowel and spectrum of consonant sounds. These results show that the simulation method for VPI speech is effective at generating the speech signals similar to actual VPI patient's speech. It is expected that the simulation speech data can be effectively employed for our future work such as acoustic model adaptation.

Effective Recognition of Velopharyngeal Insufficiency (VPI) Patient's Speech Using Simulated Speech Model (모의 음성 모델을 이용한 효과적인 구개인두부전증 환자 음성 인식)

  • Sung, Mee Young;Kwon, Tack-Kyun;Sung, Myung-Whun;Kim, Wooil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.19 no.5
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    • pp.1243-1250
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    • 2015
  • This paper presents an effective recognition method of VPI patient's speech for a VPI speech reconstruction system. Speaker adaptation technique is employed to improve VPI speech recognition. This paper proposes to use simulated speech for generating an initial model for speaker adaptation, in order to effectively utilize the small size of VPI speech for model adaptation. We obtain 83.60% in average word accuracy by applying MLLR for speaker adaptation. The proposed speaker adaptation method using simulated speech model brings 6.38% improvement in average accuracy. The experimental results demonstrate that the proposed speaker adaptation method is highly effective for developing recognition system of VPI speech which is not suitable for constructing large-size speech database.

Effective Recognition of Velopharyngeal Insufficiency (VPI) Patient's Speech Using DNN-HMM-based System (DNN-HMM 기반 시스템을 이용한 효과적인 구개인두부전증 환자 음성 인식)

  • Yoon, Ki-mu;Kim, Wooil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.23 no.1
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    • pp.33-38
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    • 2019
  • This paper proposes an effective recognition method of VPI patient's speech employing DNN-HMM-based speech recognition system, and evaluates the recognition performance compared to GMM-HMM-based system. The proposed method employs speaker adaptation technique to improve VPI speech recognition. This paper proposes to use simulated VPI speech for generating a prior model for speaker adaptation and selective learning of weight matrices of DNN, in order to effectively utilize the small size of VPI speech for model adaptation. We also apply Linear Input Network (LIN) based model adaptation technique for the DNN model. The proposed speaker adaptation method brings 2.35% improvement in average accuracy compared to GMM-HMM based ASR system. The experimental results demonstrate that the proposed DNN-HMM-based speech recognition system is effective for VPI speech with small-sized speech data, compared to conventional GMM-HMM system.

Velopharyngeal Insufficiency Induced by a Postoperative Palatal Fistula during Articulation Development Period: A Case Report (언어발달시기의 구개누공으로 인한 구개인두부전: 증례보고)

  • Baek, Rong-Min;Park, Mi-Kyong;Lee, Sang-Woo
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.175-177
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    • 2010
  • Ppupose: Velopharyngeal insufficiency (VPI) during articulation development period can cause compensatory articulation like glottal stop, which can maintain VPI symptoms such as hypernasality and nasal emission despite of recovered velopharyngeal function. Methods: A girl visited our department with speech problems such as hypernasality, compensatory articulation patterns, and nasal air emission. She had history of postpalatoplasty fistula which was repaired after 1 year follow-up. Results: After treated with speech therapy without surgery, her hypernasal speech problem was corrected. From this, we could assume that the fistula during articulation development period induced VPI, which leads to glottal substitution and this compensatory articulation maintained VPI though the fistula was repaired. Conclusion: In this report, we could observe that palatal fistula in articulation development period can have detrimental effect on articulation, and also we could confirm that evaluation of soft palate mechanism with using speech sample without compensatory articulations prevent the patient from unnecessary operation.

Velopharyngeal Insufficiency Accompanied with Hypertrophic Tonsils: A Case Report (편도비대를 동반한 구개인두부전 환자의 치험례)

  • Kim, Eun Key;Koh, Kyung Suck;Park, Mi Kyong
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.660-662
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    • 2005
  • It is well documented that adenoidectomy is attributed to hypernasality in certain cases, but not clear that the enlarged tonsils affect the quality of speech. Hypertrophied tonsils may cause and complicate the problem of velopharyngeal incompetency. The huge tonsils prevent lateral pharyngeal walls from a medial movement and interfere velar elevation, being hypernasality. Hyponasality developes as the tonsils encroach in nasopharyngeal space. Voluminous tonsils also interfere airflow in the oropharyneal passage and produce the phenomenon of cul-de-sac resonance or muffled sound. The authors and et al. present a case of velopharyngeal insufficiency accompanied with hypertrophic tonsils. Improving the lateral constricting pharyngeal wall and velar elevation after tonsillectomy minimized the velopharyngeal gap. Accordingly, the procedures of sphincter pharyngoplasty and palatal lengthening resolved the problem of hypernasality instead of pharyngeal flap. Tonsillectomy prior to pharyngeal flap surgery tends to reduce the postoperative airway problems. Sometimes, however, only tonsillectomy does without pharyngeal flap. Surgical approach by stages and intermittent evaluation are recommended at intervals of at least six weeks.