• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.555-562
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• 1996

A competent velopharyngeal sphincter is essential for intelligible speech. If the velopharyngeal incompetence exist, the seal will not be complete during speech, with a resultant hypernasal speech quality. The patient with velopharyngeal incompetence(VPI) may develope other compensatory speech problems. There are many approaches available to correct velopharyngeal incompetence, which include speech therapy, push back palatorrhaphy, pharyngeal wall implants and pharyngoplasty. This is cases report of velopharyngeal incompetence, which were successfully treated by superiorly based pharyngeal flap, covered with splitted hinge flap of nasal lining mucosa of the soft palate, named modified Hogan method. The advantages of this method are precision in the approximation of the flap due to pentagonal shaped flap design, good blood supply due to omission of the midsagittal incision on nasal lining mucosa, and simplicity than Hogan method.

• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.4 no.1
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• pp.24-32
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• 1991

Cleft palate or velopharyngeal incompetence shows many disorders and disabilities affecting speech transmission. including distortion. substitution. and the nasalization of the vowels. The nasalized vowels are produced primarily by lowering of the velum. resulting in opening a side passage for the air flow through the nasal cavity. These abnormal movements give rise to complex modification of the physical property of the sound or in the sound spectrum. The authors employed Sonagraph$^{\circledR}$ as a sound analyzer in order to ascertain the features which characterize the nasalization of vowels. Twenty healthy Korean male adult voluteers were analyzed in artificial conditions of anterior and posterior nasal obstruction. and velo-pharyngeal incompetence. The results were as follows : 1) Fundamental frequency was not changed by nasal obstruction or velopharyngeal incompetence. 2) There was no significant difference of the formant intensity between normal and nasal vowels. 3) In VPI, a decrease of the frequency of $F_2$ was observed in /e/ and /i/ vowels(p<0.001). 4) In VPI, the $F_2$ was frequently missed in /o/ and /u/ vowels. 5) In the consonant spectra of VPI, the 'release burst' was usually not observed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.3
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• pp.338-345
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• 1991

Velopharyngeal incompetence (VPI) is a condition of inadequate functional valving between the oral and nasal cavities that results in hypernasal speech and nasal air escape. VPI is caused by the following factors ; cleft palate, soft palate defect, pharyngomegaly, velopharyngeal sphincter muscle anomaly and maxillary advancement surgery, etc. Velopharyngeal function is assessed by a variety of measures that include speech evaluation, cephalogram, airflow study, videofluoroscopy and nasoendoscopy. The management of VPI is classified into four main groups ; prosthesis, insertion of implant, palatoplasty and pharyngoplasty. Pharyngeal flap is the most common surgical procedure for correcting VPI since Schoenborn's report in 1875. We report seven cases of VPI which were treated by modified modified superiorly based pharyngeal flap with good results.

• Korean Journal of Cleft Lip And Palate
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• v.15 no.1
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• pp.39-50
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• 2012

A submucous cleft palate(SMCP) is characterized by a midline deficiency or lack with/without incorrect positioning of muscular tissues in the soft palate, and by a bony defect in the midline or the center of the hard palate. Velopharyngeal incompetence(VPI) related to this SMCP has been managed by various surgical and prosthetic techniques. Because the individual diagnosis and treatment of SMCP patients was not easy to the speech pathologist and to the maxillofacial reconstructive surgeons, and for the better understanding and for the ideal approaches to the SMCP patients, we reviewed several recent articles about grading system in the SMCP caused by VPI, and summarized in this review article.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.22.1-22.4
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• 2015

Velopharyngeal dysfunction in cleft palate patients following the primary palate repair may result in nasal air emission, hypernasality, articulation disorder and poor intelligibility of speech. Among conservative treatment methods, speech aid prosthesis combined with speech therapy is widely used method. However because of its long time of treatment more than a year and low predictability, some clinicians prefer a surgical intervention. Thus, the purpose of this report was to increase an attention on the effectiveness of speech aid prosthesis by introducing a case that was successfully treated. In this clinical report, speech bulb reduction program with intensive speech therapy was applied for a patient with velopharyngeal dysfunction and it was rapidly treated by 5months which was unusually short period for speech aid therapy. Furthermore, advantages of pre-operative speech aid therapy were discussed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.1
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• pp.45-51
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• 2002

The purpose of this study is to examine the effects of vowel type on the nasalance score. Twenty one male adults without VPI produced 5 types of vowels (/a/, /e/, /i/, /o/, /u/) in two conditions-normal and simulated VPI condition. Nasalance scores were measured for each vowel. These data were compared between conditions and among vowel types. The results were as follow : For all vowels, nasalance scores were significantly higher in simulated VPI condition than in normal condition. The two conditions yielded different patterns in terms of the degree of nasalance across the 5 vowels. In normal condition, nasalance scores were higher in front vowels than in medial or back vowels. But in simulated VPI condition, nasalance scores were higher in high vowels than in mid or low vowels.

• 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 Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.81-86
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• 2000

Submucous cleft palate is a relatively uncommon congenital anomaly accompanying velopharyngeal incompetence(VPI). Double opposing Z-plasty has many advantages including prolongation of soft palate, normal midfacial growth, midline scar. We analyzed postoperative results comparing with those of preoperative evaluation by several variables(nasometer, endoscopy, satisfactory scale) in 14 patients treated with double opposing Z-plasty due to submcous cleft palate. Nasalance score in Ah sound, Ma phrase, and Pa phrase decreased 20.23%, 3.25%, and 23.26% in the average, respectively. As a result, hypernasality improved significantly. Closure rate in velum evaluated by endoscopy was increased from 0.44 to 0.76. In objective satisfactory scale checked by each patient's guardian at the postoperative period, much improved in 3, improved in 6, minimally improved in 1, and no difference in 1 was reported. (n=11 patients) Double opposing B-plasty is a good surgical modality in patients accompanying VPI with submucous cleft palate or incomplete cleft palate and will be used more usefully and widely.

• Journal of Korea Multimedia Society
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• v.22 no.2
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• pp.157-166
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• 2019

With the development of medical technology, interest in rehabilitation devices is increasing and various devices are being studied. In particular, devices for speech disorders such as hearing impairment and cleft palate are attracting attention. In general, the nasometer is used for patients with flaccid dysarthria and velopharyngeal incompetence(VPI). However, in the case of the conventional separator type nasometer, that has an acoustic feedback problem between the oral and nasal sounds. In recent, the mask type nasometer has been developed which is insensitive to acoustic feedback. But, still not popularized. In this paper, the nasometer characteristics of the conventional separation type and mask type are analyzed. Also, We were obtained clinical acoustic data from the 6 subjects and examined the significant differences in the structure of the separation type and mask type nasometer. Through experiments, it was confirmed that the measurement was about 3~15% higher in the mask type nasometer than the conventional nasometer having a separator type. Also, We was considered the necessity of nasometer signal processing for acoustic feedback reduction and nasalance calculation optimization.