鼻音计鼻音化率值与腭咽闭合状态关系的探讨

The relationship between nasalance and velopharyngeal closure status after cleft palate surgery

目的:探讨腭裂术后继发结构性语音障碍患者鼻音化率值与腭咽闭合状态的相关关系。方法:选择北京大学口腔医学院·口腔医院口腔颌面外科腭裂修复术后继发结构性语音障碍患者407个语音样本数据,应用鼻音计鼻音化率值及鼻咽纤维内镜腭咽闭合状态VAS值进行腭咽闭合功能评价。采用SPSS 13.0软件包对数据进行统计学分析。结果:407个语音样本数据鼻音化率值与VAS值呈现负相关倾向,腭咽闭合功能越差,鼻音化率值越高,296个数据具有显著相关性。其中,连续音节_([dadada])最敏感,各语音样本相关系数排序如下:R_([dadada])>R_([ta qu wu xi shi])>R_([sasasa])>R_([sisisi])>R_([dididi])>R_([papapa])>R_([i])>R_([pipipi])>R_([u])>R[wo dao hei long jiang]>R[a]。具有显著相关的296个数据依腭咽闭合状态分类统计,完全或边缘腭咽闭合鼻音化率值小于30%,轻度腭咽闭合不全鼻音化率值在30%~50%之间,中重度腭咽闭合不全鼻音化率值大于50%。结论:鼻音计应用特定语音样本,可初步提示腭裂术后继发结构性语音障碍的腭咽闭合状态,非鼻辅音的音节及语句具有较高的敏感性,单元音/a/和/u/敏感性较差。

PURPOSE:To investigate the relationship between nasalization rate and palatopharyngeal closure in patients with secondary structural speech disorder after cleft palate surgery.METHODS:A total of 407 speech samples of patients with postoperative cleft palate speech disorders without speech substitution from the Department of Oral and Maxillofacial Surgery,School of Stomatology,Peking University were included.The nasal sound meter and nasopharyngeal fiber endoscope were used to record the nasal phonation rate and the score of nasopharyngeal fiber endoscopic visual ana-log scale(VAS)of the speech samples.The nasal phonation rate values and VAS values were compared by Pearson analysis.SPSS 13.0 software package was used for data analysis.RESULTS:There was negative correlation between nasal phonetic rate and VAS value of 407 speech samples.Velopharyngeal insufficiency was worse,and nasal phonetic rate was higher.There was a significant negative correlation between nasal phonetic rate and VAS value of 296 non-nasal speech samples.According to VAS values of 296 non-nasal speech samples,it suggested if nasalance scores was below 30%,complete or marginal velopharyngeal closure was considered.If nasalance scores is between 30%and 50%,mild velopharyngeal impairment should be considered.If nasalance scores was over 50%,medium or severe velopharyngeal impairment should be considered.CONCLUSIONS:The study showed nasometer can give a clue preliminarily of the velopharyngeal closure status in patients with hypernasality and nasal air emission objectively.