• Proceedings of the KSLP Conference
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• 2003.11a
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• pp.193-194
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• 2003

목젖은 신체의 아주 조그만 부분에 불과하나 음성 언어적인 측면에서는 아주 중요한 기능을 담당하고 있다. 임상적으로 목젖의 기능이 저하되어 언어에 장애가 나타날 비인강폐쇄부전이라 말하며 일반적으로 구개열 환자들에게서 발견되나 마비성조음장애 및 뇌 손상에 의한 언어 장애 등에서도 발견되어 언어 생활 속에서 언어 장애의 벽으로 나타난다. (중략)

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.4
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• pp.517-523
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• 2000

Nasopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral cavity and the nasal cavity. It participates in physiological activities such as swallowing, breathing and pronunciation. In case of an error in this mechanism, it is called a nasopharyngeal incompetence. The causes of this error are defects in (1) length, function, posture of the soft palate (2) depth and width of the nasopharynx, (3) activity of the posterior and lateral pharyngeal wall. The purpose of this study is to analyze the nasopharynx of cleft palate patients using lateral cephalograms and at the same time, evaluate the degree of hypernasality of each vowels to find its relationship with nasopharyngeal incompetence. The following results were obtained: 1. The length of the soft palate was markedly short than normal. 2. The adequate ratio was smaller than the normal value. 3. As the adequate ratio decreased, when articulating vowels, anatomic mVPI increased. 4. When articulating each vowels, anatomic VPI was in proportion with the degree of hypernasality. 5. The degree of hypernasality was greater in high vowels(/i/, /u/) than low vowel(/a/). From the above results, it can be concluded that in cleft palate patients, lateral cephalograms can be used effectively in diagnosing and evaluating nasopharyngeal incompetence. The anatomic structure of the nasopharynx has close relation to the degree of hypernasality.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.721-728
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• 2004

Velopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral and nasal cavity. It participates in physiological activities such as swallowing, breathing and speech. It is called a velopharyngeal dysfunction when this mechanism malfunctions. The causes of this dysfunction are defects in (1) length, function, posture of the soft palate, (2) depth and width of the nasopharynx and (3) activity of the posterior and lateral pharyngeal wall. The purposes of this study are to analyze the nasopharynx of cleft palate patients using cephalometry and to evaluate the degree of hypernasality using nasometry to find its relationship with velopharyngeal dysfunction. The following results were obtained : 1. In cephalometry, there were significant differences in soft palate length, soft palate thickness, nasopharyngeal depth, nasopharyngeal area, and adequate ratio between two groups. 2. In nasometry, there were significant differences between two groups in vowel /o/ and sentences including oral consonants. 3. In cleft palate patients, though no general correlation was found between Anatomic VPI and nasalance scores, vowel /i/ and sentences including oral consonants were slightly correlated. In conclusion, cephalometry and nasometer results were significantly different between the two groups. Though in the cleft palate group, Anatomic VPI and nasalance scores, which are indices for velopharyngeal closure, excluding the vowel /i/ and sentences including oral consonants show generally no significance.

• Speech Sciences
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• v.9 no.4
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• pp.3-14
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• 2002

VPI occurs when the velum and lateral and posterior pharyngeal wall fail to separate the nasal cavity from the oral cavity during deglutition and speech. There are a number of congenital and acquired conditions which result in VPI. Congenital conditions include cleft palate, submucous cleft palate and congenital palatal insufficiency (CPI). Acquired conditions include carcinoma of the palate or pharynx and neurologic disorders. The speech characteristics of VPI is characterized by hypernasality, nasal air emission, decreased intraoral air pressure, increased nasal air flow, decreased intelligibility. VPI can be treated with various methods that include speech therapy, surgical procedures to reduce the velopharyngeal gap, speech aid prosthesis, and combination of surgery and prosthesis. This article describes four cases of VPI treated by speech aid prosthesis and speech therapy with satisfactory result.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.4
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• pp.414-421
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• 2000

The objective evaluation of velopharyngeal closure function is the key to diagnosis and therapy control of velopharyngeal incompetency. The aim of this study is to evaluate the aerodynamic and acoustic characteristics of the velopharyngeal closure function of patients who have developed velopharyngeal incompetency after management with speech aids. The test words were composed of sustained vowels /a/, /i/, /e/, /u/, /ja/, /je/, /wi/ and polysyllabic words /p'ap'i/, /siso/, /mami/ for measuring nasalance, The data was collected before the placement of the speech aids and one to three months after. The results were as follows: The nasalance score of the velopharyngeal incompetency speakers was higher than that of the normal control group, except for nasal sounds, and was decreased after placement of the speech aids, especially in high vowels /i/ (P<.01) and /wi/ (P<.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.92-96
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• 2001

Velopharyngeal function refers to the combined activity of the soft palate and pharynx in closing and opening the velopharyngeal port to the required degree. In normal speech, various muscles of palate & pharynx function as sphincter and occlude the oropharynx from the nasopharynx during the production of oral consonant sounds. Inadequate velopharyngeal function caused by neurologic disorder - cerebral apoplexy, regressive diseases - disseminated sclerosis, Parkinson's disease, congenital deformity - cleft palate, cerebral palsy and etc. may result in abnormal speech characterized by hypernasality, nasal emission and decreased intelligibility of speech due to weak consonant production. In our study, we constructed speech aids prosthesis - Palatal lift in acquired idiophathic VPI patient and assessed velopharyngeal function with various diagnostic instruments which can evaluate the speech characteristics objectively.

• Speech Sciences
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• v.3
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• pp.57-69
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• 1998

Velopharyngeal function refers to the combined activity of the soft palate and pharynx in closing and opening the velopharyngeal port to the required degree. In normal speech, during the production of oral consonant sounds elevation of the soft palate, along with the superior constrictor muscle, occludes the oropharynx from the nasopharynx. Inadequate velopharyngeal function caused by congenital or acquired insufficiency or incompetency may result in abnormal speech characterized by hypernasality, nasal emission and decreased intelligibility of speech due to weak consonant production. The speech aid is often helpful in improving the speech of individuals with velopharyngeal incompetency. In this article, the pathogenesis and treatment of velopharyngeal incompetence are discussed and a speech aid appliance that was constructed for the patient is described.

• Proceedings of The Korean Cleft Lip And Palate Association
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• 2002.05a
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• pp.40-40
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• 2002

• Korean Journal of Cleft Lip And Palate
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• v.8 no.1
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• pp.39-44
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• 2005

Velopharyngeal incompetence(VPI) is that soft palate and muscle of posterolateral pharyngeal wall can not close velopharyngeal port properly. Thing that prior to treatment for patient with VPI is to evaluation about nasopharyngeal closing function. This data is important for making a treatment plan and assesment of treatment effect to improve nasopharyngeal closing function. There are two ways of VPI assessment. The one is subjective method by auditory finding, the other is objective method by using equipment for language test. Using only subjective way is not adequate for evaluation of VPI because of low trust, so doing both two methods simultaneously help to make a diagnosis and assessment exactly. CPAP is effective method to treat hypernasality. This new treatment technique intensify oropharyngeal muscle for nasopharyngeal closing by direct resistance training. Becase conventional treatments have limitation, so many research about treatment effectiveness of CPAP are being studied. This study aims that we compare our result from Korean VPI patients with result about treatment effect in other advanced country, to make CPAP Treatment Questionares and to find ways that improve oropharyngeal closing function an[1 maximally increase language treatment effect.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.454-458
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• 2010

Velopharyngeal insufficiency is defined as a status in which nasal cavity and oral cavity can not be sepa-rated when speaking, swallowing by any reason. It has been treated by palatorrhaphy, pharyn-geal flap, local flap, free flap etc. When the size of the defect is small, it can be restored by palatorrhaphy, pharyngeal flap etc. But they are not proper for treatment of the large size of defect. In that case, local flap and free flap are more beneficial. Although large defect can be restored by free flap technique, but it is very complex, time-consuming and may bring about esthetical, functional complications of donor site. Buccinator myomucosal flap is a kind of local flap and reported for the first time by Bozola et al in 1989 and it has become a useful way for reconstruction of large intraoral defect. Authors experienced the use of buccinators myomucosal flap for treating secondary velopharyngeal insufficiency with large soft palate defect and obtained good result. So we report the case with literature reviews.