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Secondary cleft surgery
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Continuous perceptual speech evaluation is the primary tool for evaluating VPD. The longitudinal evaluation of speech intelligibility can begin shortly after palate repair. Early identification and correction of VPD is critical to avoid the development of compensatory misarticulations. Characteristics of VPD include hypernasal resonance, nasal escape, nasal turbulence and inadequate intraoral air pres- sure.10 In addition to perceptual speech evaluation, videofluoroscopy, nasal endoscopy and nasometry might be useful in identifying the size and nature of the velopharyngeal defect.
Nasalance in adolescents with autism spectrum disorders
Published in International Journal of Speech-Language Pathology, 2020
Rachel Kasthurirathne, Karen Forrest, Jared Ross, Rita Patel
Nasalance scores are acoustic ratios that quantify the relative nasal energy in a speech sample. Whereas acoustic measures of nasality typically are derived from spectral characteristics of the combined oral and nasal cavities (e.g. A1-P0 and A1-P1; Chen, 1997), nasalance scores are calculated from the energy emitted from each cavity independently. As such, it may be more closely affiliated with velopharyngeal and oral opening. Nasalance is derived from computer-based nasometry systems such as the Nasometer II Model 6450 (PENTAX Medical), wherein a speech-language pathologist or researcher positions a sound separator plate perpendicularly against a speaker’s philtrum to partition oral and nasal energy during speech production. Superior and inferior microphones located on either side of the plate collect nasal and oral energy respectively. The Nasometer II applies a 300 Hz bandpass filter centred at 500Hz to the input and then digitises the signals for calculation of nasalance using the following equation: nasalance (%) = nasal energy (dB)/[nasal energy (dB) + oral energy (dB)]×100 (Fletcher, 1976). Nasalance scores traditionally serve to corroborate and quantify any perceived nasal abnormality in a speech sample (Whitehill & Lee, 2008); however, researchers have also used nasalance scores to characterise oral-nasal balance disorders prior to auditory-perceptual assessment (de Boer, Marino, de Cassia Rillo Dutka, Pegoraro-Krook, & Bressmann, 2018).
Validity of test stimuli for nasalance measurement in speakers of Jordanian Arabic
Published in Logopedics Phoniatrics Vocology, 2018
Fadwa A. Khwaileh, Firas S. D. Alfwaress, Ann W. Kummer, Ma’moun Alrawashdeh
Watterson et al. (29) criticized the Rainbow Passage and the Zoo Passages as being long, syntactically complex and too difficult for young children to recite. They recommended the use of age appropriate stimuli for obtaining nasometry data. They introduced the Turtle passage and the Mouse Passage that paralleled the Zoo Passage and Rainbow passage, respectively. These two passages were short with simple syntactic structure and vocabulary content, and thus appropriate for young children. The Turtle Passage was found to yield similar nasalance measures as the Zoo passage in the children who were examined. In addition, the use of the Rainbow Passage offered no additional information beyond those obtained by the Zoo Passage and Nasal Sentences (11).
Velopharyngeal incompetence following transoral robotic surgery for oropharyngeal carcinoma: A scoping review
Published in International Journal of Speech-Language Pathology, 2023
Emma Charters, Claire Pelham, Daniel Novakovic, Cate Madill, Jonathan Clark
The changes to speech and swallowing function associated with the various surgical and non-surgical approaches are becoming increasingly relevant as the prognosis of patients with OPC improves and a younger cohort of patients are affected (Chaturvedi, 2012). VPI specifically can result in nasal emission, altered speech resonance and intelligibility, and food or fluids entering the nasal cavity during meals (Willging, 2003). This can lead to substantial social and financial impairment leading to distress and anxiety (Lu, O’Sullivan, & Sharp, 2019; Wu et al., 2016). VPI assessment has been primarily drawn from craniofacial studies (Shprintzen & Marrinan, 2009). Both videofluroscopy swallowing studies and nasendoscopy can both provide a physiological and structural evaluation as to the cause and severity of VPI. They also are both able to guide indication and selection of any surgical management (Shprintzen & Marrinan, 2009). Nasometry has been shown to have good correlation with perceptual ratings of hyper-nasality, however both assessments are required to achieve confidence in clinical findings (Sweeney & Sell, 2008). These approaches can be directly translated to an adult oncology population and involve validated measures of speech using a nasometer (nasalance), voice analysis software and gold standard swallowing evaluation using videofluroscopy or endoscopy (Impieri et al., 2017). Perceptual measures, which rely on the clinician listening for articulation imprecision, hypernasality or nasal emission within a speech sample, are also frequently used but are prone to subjectivity and bias (Paniagua, Signorini, da Costa, Collares, & Dornelles, 2013).