Comparing the Temporal Aspects of Velopharyngeal Closure in Children with and without Cleft Palate

2021 ◽  
pp. 1-13
Author(s):  
Hilal Burcu Ozkan ◽  
Mavis Emel Kulak Kayikci ◽  
Riza Onder Gunaydin ◽  
Fatma Figen Ozgur
Keyword(s):  
Cleft Palate ◽  
Vowel Sound ◽  
Temporal Parameters ◽  
Closure Duration ◽  
Appropriate Treatment ◽  
Temporal Aspects ◽  
Velopharyngeal Closure ◽  
Nasal Consonant ◽  
Treatment Procedures ◽  
Turkish Language

<b><i>Introduction:</i></b> Children with cleft palate exhibit differences in the 4 temporal components of nasalization (nasal onset and offset intervals, nasal consonant duration, and total speech duration), with various patterns having been noted based on different languages. Thus, the current study aimed to examine the temporal aspects of velopharyngeal closure in children with and without cleft palate; this is the first study to do so in the Turkish language. <b><i>Methods:</i></b> This study evaluated and compared the 4 temporal characteristics of velopharyngeal closure in children (aged 6–10 years) with (<i>n</i> = 28) and without (<i>n</i> = 28) cleft palate using nonword consonant and vowel speech samples, including the bilabial nasal-to-stop combination /mp/ and the velar nasal-to-stop combination /ηk/. Acoustic data were recorded using a nasometer, after which acoustic waveforms were examined to determine the 4 temporal components of nasalization. Flexible nasoendoscopy was then used to evaluate velopharyngeal closure patterns. <b><i>Results:</i></b> With regard to the 4 closure patterns, significant differences in the nasal offset interval (<i>F</i><sub>4–25</sub> = 10.213, <i>p</i> = 0.04; <i>p</i> &#x3c; 0.05) and the nasal consonant duration ratio (<i>F</i><sub>4–25</sub> = 12.987, <i>p</i> = 0.02; <i>p</i> &#x3c; 0.05) were observed for only /ampa/. The coronal closure pattern showed the longest closure duration (0.74 s). Children with cleft palate showed prolonged temporal parameters in all 4 characteristics, reflecting oral-nasal resonance imbalances. In particular, the low vowel sound /a/ was significantly more prolonged than the high vowel sounds /i/ and /u/. <b><i>Conclusions:</i></b> The examined temporal parameters offer more accurate characterizations of velopharygeal closure, thereby allowing more accurate clinical assessments and more appropriate treatment procedures. Children with cleft palate showed longer nasalization durations compared to those without the same. Thus, the degree of hypernasality in children with cleft palate may affect the temporal aspects of nasalization.

Special Considerations for Evaluation and Treatment of Spanish-Speaking Patients with Cleft Palate

2016 ◽  
Vol 1 (5) ◽  
pp. 41-49
Author(s):  
Ellen Moore
Keyword(s):  
Cleft Palate ◽  
The United States ◽  
Culturally Competent ◽  
Speech Language Pathology ◽  
Spanish Speaking ◽  
Appropriate Treatment ◽  
Oral Pressure ◽  
Language Pathology ◽  
History Of ◽  
Spanish Speaking Population

As the Spanish-speaking population in the United States continues to grow, there is increasing need for culturally competent and linguistically appropriate treatment across the field of speech-language pathology. This paper reviews information relevant to the evaluation and treatment of Spanish-speaking and Spanish-English bilingual children with a history of cleft palate. The phonetics and phonology of Spanish are reviewed and contrasted with English, with a focus on oral pressure consonants. Cultural factors and bilingualism are discussed briefly. Finally, practical strategies for evaluation and treatment are presented. Information is presented for monolingual and bilingual speech-language pathologists, both in the community and on cleft palate teams.

scholarly journals Microwave and Ultrasound Based Methods in Sludge Treatment: A Review

2021 ◽  
Vol 11 (15) ◽  
pp. 7067
Author(s):  
Zoltán Jákói ◽  
Balázs Lemmer ◽  
Cecilia Hodúr ◽  
Sándor Beszédes
Keyword(s):  
Wastewater Sludge ◽  
Process Efficiency ◽  
H2o2 Treatment ◽  
Treatment Conditions ◽  
Appropriate Treatment ◽  
Scientific Papers ◽  
Health Related ◽  
Scientific Results ◽  
Treatment Procedures ◽  
Anaerobic Digestibility

The amount of waste activated sludge (WAS) is increasing annually, and since it presents potential environmental and health-related risks, an appropriate treatment and stabilization process is needed. It has been shown in numerous studies in the past few decades that amongst the advanced treatment methods of sludge, microwave and ultrasound-based processes offer promising and effective alternatives. The main advantage of these physical methods is that they are energy-efficient, easy to implement and can be combined with other types of treatment procedures without major difficulties. In this review article we would like to present the recent scientific results of the microwave, ultrasound and combined (microwave-alkaline, microwave-H2O2, ultrasound-alkaline and ultrasound-H2O2) treatment of wastewater sludge, in terms of different process-efficiency indicators. Although the obtained results somewhat vary between the different scientific papers, it can be undoubtedly stated that both MW and US—either individually or in combination with chemical treatments—can enhance several aspects of sludge processing, like increasing the SCOD/TCOD rate, disintegration degree (DD), or the anaerobic digestibility (AD), but the extent of these increments clearly depends on the treatment conditions or parameters.

A Comparison of Oral-Nasal Balance Patterns in Speakers who are Categorized as “Almost but Not Quite” and “Sometimes but Not Always”

2004 ◽  
Vol 41 (5) ◽  
pp. 526-534 ◽  
Author(s):  
David L. Jones ◽  
Hughlett L. Morris ◽  
Duane R. Van Demark
Keyword(s):  
Cleft Palate ◽  
Care Center ◽  
Tertiary Care ◽  
Area Under The Curve ◽  
Mean Amplitude ◽  
Tertiary Care Center ◽  
Craniofacial Anomalies ◽  
Time Integral ◽  
Temporal Aspects ◽  
Perceptual Assessment

Objective The purpose of this study was to determine whether amplitude or temporal patterns of oral-nasal balance differentiate speakers with cleft palate who are classified as belonging to the “almost but not quite” (ABNQ) and “sometimes but not always” (SBNA) subgroups of marginal velopharyngeal inadequacy. Design The nasal accelerometric vibrational index (NAVI) was used to measure amplitude and temporal aspects of oral-nasal balance during the productions of oral and nasal syllables, words, and sentences. NAVI measures obtained include mean amplitude, time integral (area under the curve), duration, rise time, and fall time. Setting Tertiary care center for patients with cleft palate–craniofacial anomalies. Participants Seventeen patients with repaired cleft palate who were assigned by perceptual assessment to the ABNQ subgroup and 17 patients who were assigned to the SBNA subgroup. Results No differences were found between the ABNQ and SBNA subgroups with regard to patterns of nasalization. Further analysis as a function of level of production and phonetic context revealed no differences between the subgroups. Conclusions Although clinicians may report perceived differences in the resonance patterns of speakers who fall within the category of marginal velopharyngeal inadequacy, further division into the ABNQ and SBNA subgroups has yet to be validated.

Nasalization Amplitude-Timing Characteristics of Speakers With and Without Cleft Palate

2017 ◽  
Vol 55 (1) ◽  
pp. 45-56 ◽  
Author(s):  
Youkyung Bae
Keyword(s):  
Cleft Palate ◽  
Model Fit ◽  
Temporal Domain ◽  
Temporal Relationships ◽  
Practical Guidelines ◽  
Rate Controlled ◽  
The Mean ◽  
Nasal Consonant ◽  
Accuracy Rates ◽  
Nasal Resonance

Objectives: To examine the amplitude-temporal relationships of acoustic nasalization in speakers with a range of nasality and to determine the extent to which each domain independently predicts the speaker’s perceived oral-nasal balance. Design: Rate-controlled speech samples, consisting of /izinizi/, /azanaza/, and /uzunuzu/, were recorded from 18 participants (14 with repaired cleft palate and 4 without cleft palate) using the Nasometer. The mean nasalance of the entire mid-vowel–nasal consonant–vowel (mid-VNV) sequence (amplitude-domain) and the duration of the nasalized segment of the mid-VNV sequence (temporal-domain) were obtained based on nasalance contours. Results: Strong linear and vowel-dependent relationships were observed between the 2 domains of nasalization (adjusted R2 = 71.5%). Both the amplitude- and temporal-domain measures were found to reliably predict the speaker’s perceived oral-nasal balance, with better overall model fit and higher classification accuracy rates observed in /izinizi/ and /uzunuzu/ than in /azanaza/. Despite poor specificity, the temporal-domain measure of /azanaza/ was found to have a strong correlation with the participants’ Zoo passage nasalance scores ( rs = .897, p < .01), suggesting its potential utility as a severity indicator of perceived nasality. Conclusions: With the use of relatively simple speech tasks and measurements representing the amplitude and temporal domains of nasalization, the present study provided practical guidelines for using the Nasometer in assessing patients with oral-nasal resonance imbalance. Findings suggest that both domain measures of nasalization should be examined across different vowel contexts, given that each domain may provide clinically relevant, yet different, information.

Change in Levator Veli Palatini Muscle Activity for Patients with Cleft Palate in Association with Placement of a Speech-Aid Prosthesis

2002 ◽  
Vol 39 (5) ◽  
pp. 503-508 ◽  
Author(s):  
Takashi Tachimura ◽  
Kanji Nohara ◽  
Yoshinori Fujita ◽  
Takeshi Wada
Keyword(s):  
Cleft Palate ◽  
Pressure Change ◽  
Mean Value ◽  
Emg Activity ◽  
Reserve Capacity ◽  
Activity Levels ◽  
Levator Veli Palatini ◽  
Velopharyngeal Incompetence ◽  
Velopharyngeal Closure ◽  
The Mean

Objective: The purpose of this study was to examine whether a speech-aid prosthesis normalizes the activity of the levator veli palatini muscle for patients with cleft palate who exhibit velopharyngeal incompetence. Design: Each subject was instructed to produce repetitions of /mu/, /u/, /pu/, /su/, and /tsu/ and to blow with maximum possible effort. Electromyographic (EMG) activity of the levator veli palatini muscle was recorded with and without a hybrid speech-aid prosthesis in place. Participants: The participants were five patients with repaired cleft palate who were routinely wearing a hybrid speech-aid prosthesis. Results: With the prosthesis in place, the mean value of levator activity changed positively in relation to oral air-pressure change during blowing. Differences in levator activity in relation to speech samples were similar to those in normal speakers. With the prosthesis in place, levator activity for speech tasks was less than 50% of the maximum levator activity for all subjects. The findings were similar to those reported previously for normal speakers. Conclusion: Placement of the prosthesis changed EMG activity levels of the levator veli palatini muscle to levels that are similar to normal speakers. It is possible that, with the increase in the differential levator activity between speech and a maximum force task, the velopharyngeal mechanism has a greater reserve capacity to maintain velopharyngeal closure compared with the noprosthesis condition.

Induced Velopharyngeal Fatigue Effects in Speakers with Repaired Palatal Clefts

2007 ◽  
Vol 44 (3) ◽  
pp. 251-260 ◽  
Author(s):  
Jerald B. Moon ◽  
David P. Kuehn ◽  
Grace Chan ◽  
Lili Zhao
Keyword(s):  
Cleft Palate ◽  
Muscle Activity ◽  
Regression Line ◽  
Pressure Load ◽  
Nasal Side ◽  
Velopharyngeal Closure ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Nasal Pressure ◽  
Force Data

Objective: To address whether speakers with cleft palate exhibit velopharyngeal mechanism fatigue and are more susceptible to muscle fatigue than are speakers without cleft palate. Methods: Six adults with repaired palatal clefts and mild-moderate hypernasality served as subjects. Velopharyngeal closure force and levator veli palatini muscle activity were recorded. Subjects were asked to repeat /si/ 100 times while an external load consisting of air pressure (0, 5, 15, 25, 35 cm H2O) was applied via a mask to the nasal side of the velopharyngeal mechanism. Fatigue was defined as a reduction in velopharyngeal closure force across the series of /si/ productions, as evidenced by a negatively sloped regression line fit to the closure force data. Results: Absolute levels of velopharyngeal closure force were much lower than those observed previously in speakers without palatal clefts. All subjects showed evidence of fatigue. Furthermore, all subjects demonstrated exhaustion, where they were unable to close the velopharyngeal port against the nasal pressure load. This occurred at pressure load levels lower than those successfully completed by speakers without cleft palate. Conclusions: In speakers with a repaired palatal cleft, the velopharyngeal closure muscles may not possess the same strength and/or endurance as in normal speakers. Alternatively, muscles may possess adequate strength, but not be positioned optimally within the velopharynx following cleft palate repair or may be forced to move velopharyngeal structures that are stiffer as a result of surgical scarring.

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