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Shin, Yu-Jeong,Ko, Seung-O Korean Association of Maxillofacial Plastic and Re 2015 Maxillofacial Plastic Reconstructive Surgery Vol.37 No.-
Velopharyngeal dysfunction in cleft palate patients following the primary palate repair may result in nasal air emission, hypernasality, articulation disorder and poor intelligibility of speech. Among conservative treatment methods, speech aid prosthesis combined with speech therapy is widely used method. However because of its long time of treatment more than a year and low predictability, some clinicians prefer a surgical intervention. Thus, the purpose of this report was to increase an attention on the effectiveness of speech aid prosthesis by introducing a case that was successfully treated. In this clinical report, speech bulb reduction program with intensive speech therapy was applied for a patient with velopharyngeal dysfunction and it was rapidly treated by 5months which was unusually short period for speech aid therapy. Furthermore, advantages of pre-operative speech aid therapy were discussed.
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고승오,강성현,엄병구,박윤하 대한구순구개열학회 2018 대한구순구개열학회지 Vol.21 No.1
The nasal and oral cavity must be completely closed off while swallowing, vomiting, blowing, sucking, whistling and speaking oral sounds. This velopharyngeal closure is especially important when producing pressure-sensitive sounds. During normal velopharyngeal (VP) function, posterior third of soft palate moves posterior-superiorly, pharyngeal wall moves anteriorly and medially to form a shape of a sphincter resulting the closure of oral and nasal cavities. Velopharyngeal dysfunction (VPD) is a term describing an inappropriate function of VP port which consists of lateral and posterior pharyngeal walls and soft palate. This muscular valve can control the air passage between oro- and nasopharynx. The impairment of velopharyngeal function can be attributed to structural causes, neurologic causes and speech mislearning. Diagnosis of VPD, identifying a critical cause of the dysfunction, can be carried out through physical and oral examination, perceptual speech assessment, radiographic mulitplanar videofluoroscopy and nasendoscopy. Treatment options of VPD include surgical and prosthetic interventions in combination with speech therapy. Speech therapy is the mainstay in treatment of patients with VPD. Prosthetic devices for VPD can be alternative treatment method when surgical approach is not considered. Widely used types of these devices, called speech aids, are palatal lift appliance and speech bulb.
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