腭裂术后患者发音时表情扭曲与构音的关系研究

Relationship between the facial grimace and articulation of patients with repaired cleft palate

目的研究腭裂术后存在腭咽闭合不全或腭瘘的患者在发音时面部表情扭曲与构音的关系。方法选择98例腭裂术后腭咽闭合不全或有腭瘘且发音时有表情扭曲的患者,观察并记录患者发音时的面部表情扭曲情况。将表情扭曲根据部位分为鼻部扭曲和面部扭曲,根据构音方式及构音位置分别分析表情扭曲与构音的关系。结果按构音方式分类,98例腭裂术后患者鼻部扭曲的发生率从高到低依次为塞音57.14%(56例)、擦音51.02%(50例)、塞擦音35.71%(35例),面部扭曲的发生率依次为塞音42.86%(42例)、擦音38.78%(38例)、塞擦音30.61%(30例);按构音位置分类,鼻部和面部表情扭曲的发生率最高为双唇音,最低为喉音,发其他辅音,包括舌尖中音、舌面后音、舌尖前音、舌根音和舌面音时均可出现。结论腭裂术后患者发所有塞音、擦音和塞擦音等压力性辅音时都可以出现表情扭曲动作;发音方式相同的音,随发音部位后移,表情扭曲的发生率降低;辅音省略、代偿较严重的患者,少有表情扭曲动作发生。

Objective To investigate the correlation between articulation of pressure-sensitive phonemes and nasal/facial grimace of patients with repaired cleft palate.Methods This study included 98 patients of repaired cleft palate with nasal/facia during speech.Each patient underwent subjective speech assessment.The incidence and distribution of nasal/facial grimace during pressure-sensitive phonemes were summarized focusing on manners and places of articulation.Results The articulation manners of the highest incidence rate for nasal grimace were stops 57.14%(56 cases),fricatives 51.02%(50 cases),and affricates 35.71%(35 cases),whereas those for facial grimace were 42.86%(42 cases),38.78%(38 cases),and 30.61%(30 cases).The articulation area of the highest incidence rate for nasal and facial grimace was bilabial,the lowest incidence rate was guttural,and other consonants,including lingua-palatal,blade-alveolar,alveolar,velar,and supradental.Conclusion Facial grimace is the most common speech disorder of patients with cleft palate,occurring in all stops,fricatives,and affricates.With the same articulation manners,the incidence of facial grimace decreased as the articulation places moved back.The children with severe consonant loss and compensation had minimal facial grimace.