唇腭裂患者上颌骨牵引成骨术后[i]和[s]声学特性的变化

Acoustic characteristic changes of [i] and [s] in cleft lip and palate patients after maxillary distraction osteogenesis

目的:通过研究行颅外支架式上颌骨牵引成骨术(rigid external distraction,RED)的唇腭裂患者治疗前后元音[i]和擦音[s]的声学特性变化,分析上颌骨牵引成骨术对患者腭咽闭合功能和舌位的影响。方法:1999年至2001年行颅外支架式上颌骨牵引成骨术的唇腭裂术后上颌发育不足患者21例,其中男性13例,女性8例,平均年龄15.05岁。所有患者RED手术前后测量元音[i]擦音[s]的声学指标。用非参数检验比较治疗前后[i]和[s]声学特性的变化,并绘制[i]的声学舌位图。结果:RED后患者元音[i]基频能量明显加强,擦音[s]的能量明显降低。RED前后元音[i]声学舌位图上舌位无明显变化,RED后擦音[s]强频区向高频区移动。结论:唇腭裂患者经RED前移上颌骨后,腭咽闭合功能恶化,鼻腔共鸣增加,辅音趋向无力,同时发音时舌向前运动增加。

PURPOSE:This study was conducted to evaluate the acoustic characteristic changes of the vowel [i] and fricative [s] after maxillary distraction osteogenesis by using a rigid external distraction device (RED) in cleft lip and palate patients with maxillary dysplasia. Methods: Twenty-one cleft lip and palate patients with maxillary dysplasia were included in this study. There were 13 male and 8 female patients, with an average age of 15.05 years. All the patients underwent maxillary advancement with rigid external distraction after a high Le Fort Ⅰ osteotomy. Acoustic characteristic of the vowel [i] and the fricative [s] before and after RED were measured by CSL-4300B and compared by non-parametric test. Results: The energy of the fundamental frequency of [i] increased significantly after RED while the energy of [s] decreased evidently. Acoustic plot of tongue position of [i] showed no change and the frequency of [s] tended to be higher.Conclusion: After RED, the velopharyngeal function deteriorated which leaded to increase of hypernasality and weakness of consonant, while the tongue moved forward more than before RED.