Achados espectrais das vogais [a] e [ã] em diferentes aberturas velofaríngeas

BACKGROUND: the size control of velopharyngeal opening is an important variable for the acoustic profile characterization of hypernasal speech. AIM: to investigate frequency spectral aspects of F1, F2, F3, nasal formant (FN) and anti-formant, in Hertz, for vowels [a] and at different velopharyngeal openings produced in the bulb of a palatal prosthesis replica used by a patient with velopharyngeal insufficiency. METHOD: speech recordings were obtained for four words (pato/mato and panto/manto) produced within a carrier phrase in 5 conditions of velopharyngeal functioning: prosthesis with no openings (control condition: CC); prosthesis with bulb opening of 10mm² (experimental condition with 10mm² opening: EC10), prosthesis with a 20mm² opening (EC20), prosthesis with a 30mm² openning (EC30), and without the prosthesis (ECO). Five speech-language pathologists made a live rating of speech nasality during the reading of an oral passage. The recordings were used for spectral analysis. RESULTS: F1 values were significantly higher for [a] when compared to in all conditions. F2 values for [a] in EC20 and EC30 were significantly lower than values in the other conditions, being closer to the values presented for . F3 values were not significantly different between the testing conditions. There was a relationship between FN and anti-formants, and the auditory perception of nasality for conditions EC10 and EC20. CONCLUSION: significant changes were observed in the studied spectral values according to changes in the velopharyngeal opening size.TEMA: o controle do tamanho da abertura velofaríngea é uma variável importante na caracterização do perfil acústico da fala hipernasal. OBJETIVO: investigar os aspectos espectrais das frequências de F1, F2, F3, formante nasal(FN) e anti-formante, em Hertz, para as vogais [a] e [ã] na presença de aberturas feitas no bulbo de réplicas da prótese de palato de uma paciente com insuficiência velofaríngea. MÉTODO: gravações de produções de quatro palavras (pato/mato e panto/manto) inseridas em frase veículo foram obtidas em cinco condições de funcionamento velofaríngeo: prótese sem aberturas (condição controle: CC), prótese com abertura de 10mm² no bulbo (condição experimental - CE10), com abertura de 20mm² (condição experimental - CE20), com abertura de 30mm² (condição experimental - CE30), e sem prótese (condição experimental aberta - CEA). Cinco fonoaudiólogos julgaram a nasalidade de fala ao vivo, durante a leitura de um texto oral. As gravações foram usadas para análise espectral. RESULTADOS: valores de F1 foram significativamente mais altos para [a] que para [ã] em todas as condições. Valores de F2 para [a] em CE20 e CE30 foram significantemente mais baixos que nas outras condições, aproximando-se dos valores para [ã]. Valores de F3 não foram significativamente diferentes nas diferentes condições. Houve relação entre os achados de FN e anti-formantes e a percepção de nasalidade para as condições CE10 e CE20. CONCLUSÃO: foram observadas mudanças significativas nos valores espectrais estudados de acordo com alterações no tamanho da abertura velofaríngea.Universidade Estadual de Campinas Instituto de Estudos da LinguagemUniversity of FloridaUniversidade de São Paulo Hospital de Reabilitação de Anomalias Craniofaciais Laboratório de Fonética ExperimentalUniversidade Estadual de São Paulo Departamento de FonoaudiologiaUniversidade Federal de São Paulo (UNIFESP)USP Faculdade de Odontologia de Bauru Departamento de FonoaudiologiaUniversidade Estadual de Campinas Instituto de Estudos da Linguagem Departamento de LinguísticaUNIFESPSciEL

Speech nasality and nasometry in cleft lip and palate

AbstractIntroductionPerceptual evaluation is considered the gold standard to evaluate speech nasality. Several procedures are used to collect and analyze perceptual data, which makes it susceptible to errors. Therefore, there has been an increasing desire to find methods that can improve the assessment.ObjectiveTo describe and compare the results of speech nasality obtained by assessments of live speech, the Test of Hypernasality (THYPER), assessments of audio recorded speech, and nasometry.MethodsA retrospective study consisting of 331 patients with operated unilateral cleft lip and palate. Speech nasality was assessed by four methods of assessment: live perceptual judgement, THYPER, audio-recorded speech sample judgement by multiple judges, and nasometry. All data were collected from medical records of patients, with the exception of the speech sample recording assessment, which was carried out by multiple judges.ResultsThe results showed that the highest percentages of absence of hypernasality were obtained from judgements performed live and from the THYPER, with equal results between them (79%). Lower percentages were obtained from the recordings by judges (66%) and from nasometry (57%).ConclusionThe best results among the four speech nasality evaluation methods were obtained for the ones performed live (live nasality judgement by a speech pathologist and THYPER)

Assessment of speech nasality in children with Robin Sequence

PURPOSE: To report the outcomes of primary palatoplasty in Robin Sequence (RS); to verify the relationship between modalities of assessment of nasality; to compare nasality between techniques at palatoplasty.METHODS: This study involved the identification of hypernasality in four modalities: live assessment with 4-point scale; live assessment with cul-de-sactest; multiple listeners' ratings of recorded phrase; nasometric assessment. Live ratings of speech nasality and nasalance scores were retrieved from charts, while a recorded phrase was rated by listeners for occurrence of hypernasality. Agreement between the modalities was established as well as association between nasality, nasal turbulence and age at surgery and at assessment. Fisher's exact test was used to compare findings between surgical techniques.RESULTS: Agreement between nasalance, live assessment with 4-point scale, live assessment with cul-de-sac, and multiple listeners' ratings of recorded samples ranged between reasonable (0.32) and perfect (1.00). Percentage occurrence of hypernasality varied largely between assessment modalities. Mean occurrence of hypernasality was lower for the group submitted to Furlow technique (26%) than the group that received von Langenbeck technique (53%). Only findings obtained live were statistically significant (scale: p=0.012; cul-de-sac:p<0.001). Listeners identified nasal turbulence for 22 (32%) samples out of the 69 recordings, and an association was found between hypernasality and nasal turbulence.CONCLUSION: Lower occurrence of hypernasality was identified for patients with RS in Furlow group. Identification of hypernasality varied largely among the four assessment modalities

Prótese de palato em sujeitos com disfunção velofaríngea: expectativa e ansiedade

Cleft lip and palate (CLL) is a very common craniofacial anomaly. The cleft is usually corrected with surgery which may fail resulting in velopharyngeal dysfunction (VPD). The use of palatal prosthesis is an alternative treatment for correcting both, CLP and VPD. This study evaluated anxiety symptoms expectations of subjects of both genders, with velopharyngeal dysfunction, referred to palatal prosthesis program for VPD treatment. In this cross sectional and descriptive study 30 subjects with velopharyngeal dysfunction, aged 15 to 64 years old (mean age of 28) were interviewed at the Hospital for Rehabilitation of Craniofacial Anomalies (HRAC). All subjects referred to the palatal prosthesis program at HRAC in the year of 2005 were considered for participation in the study but only the first 30 candidates were included. A questionnaire addressing expectation elaborated by the researcher and the Beck Scale on anxiety were used. All subjects showed expectation regarding speech modification. Changes in professional and affective aspects of their lives after changes in speech were obtained with palatal prosthesis were the most reported expectations. Subjects’ age and gender influenced anxiety levels significantly which were minimum across subjects. High levels of expectation were more frequent than anxiety in the sample population.Considerando que fissura labiopalatina é uma anomalia importante em nossa realidade clínica, que os procedimentos cirúrgicos têm como objetivo restaurar a forma e a função normal das estruturas alteradas, e que muitas vezes sujeitos com esse tipo de malformação por motivos variados não podem se beneficiar dessa forma de tratamento, sendo indicados outros procedimentos, como, a utilização de Prótese de Palato (PP), o presente estudo tem como objetivo mensurar a gravidade dos sintomas de ansiedade e verificar a expectativa de sujeitos com disfunção velofaríngea (DVF), indicados à colocação da PP. São analisados 30 sujeitos do Hospital de Reabilitação de Anomalias Craniofaciais da USP com DVF, de ambos os gêneros, na faixa etária de 15 a 64 anos, com idade média de 28 anos. Como instrumentos de natureza psicológica, são utilizados um questionário de expectativa formulado pela primeira pesquisadora e o Inventário de Ansiedade de Beck. Ocorre expectativa com relação à modificação da fala em todos os sujeitos referente à: mudança nos aspectos profissional e afetivo, que é a mais relatada; idade e gênero não são fatores relevantes nos níveis de ansiedade; o nível mínimo de ansiedade é o de maior ocorrência, sendo que a expectativa aparece com menor frequência que a ansiedade

Spectral Findings For Vowels [a] And [ã] At Different Velopharyngeal Openings.

The size control of velopharyngeal opening is an important variable for the acoustic profile characterization of hypernasal speech. To investigate frequency spectral aspects of F1, F2, F3, nasal formant (FN) and anti-formant, in Hertz, for vowels [a] and [ã] at different velopharyngeal openings produced in the bulb of a palatal prosthesis replica used by a patient with velopharyngeal insufficiency. Speech recordings were obtained for four words (pato/mato and panto/manto) produced within a carrier phrase in 5 conditions of velopharyngeal functioning: prosthesis with no openings (control condition: CC); prosthesis with bulb opening of 10 mm² (experimental condition with 10 mm² opening: EC10), prosthesis with a 20 mm² opening (EC20), prosthesis with a 30 mm² opening (EC30), and without the prosthesis (ECO). Five speech-language pathologists made a live rating of speech nasality during the reading of an oral passage. The recordings were used for spectral analysis. F1 values were significantly higher for [a] when compared to [ã] in all conditions. F2 values for [a] in EC20 and EC30 were significantly lower than values in the other conditions, being closer to the values presented for [ã]. F3 values were not significantly different between the testing conditions. There was a relationship between FN and anti-formants, and the auditory perception of nasality for conditions EC10 and EC20. Significant changes were observed in the studied spectral values according to changes in the velopharyngeal opening size.22515-2

Achados espectrais das vogais [a] e [ã] em diferentes aberturas velofaríngeas

BACKGROUND: the size control of velopharyngeal opening is an important variable for the acoustic profile characterization of hypernasal speech. AIM: to investigate frequency spectral aspects of F1, F2, F3, nasal formant (FN) and anti-formant, in Hertz, for vowels [a] and <img border=0 width=32 height=32 src=/img/revistas/pfono/v22n4/en_26x03.jpg align=absmiddle>at different velopharyngeal openings produced in the bulb of a palatal prosthesis replica used by a patient with velopharyngeal insufficiency. METHOD: speech recordings were obtained for four words (pato/mato and panto/manto) produced within a carrier phrase in 5 conditions of velopharyngeal functioning: prosthesis with no openings (control condition: CC); prosthesis with bulb opening of 10mm² (experimental condition with 10mm² opening: EC10), prosthesis with a 20mm² opening (EC20), prosthesis with a 30mm² openning (EC30), and without the prosthesis (ECO). Five speech-language pathologists made a live rating of speech nasality during the reading of an oral passage. The recordings were used for spectral analysis. RESULTS: F1 values were significantly higher for [a] when compared to <img border=0 width=32 height=32 src=/img/revistas/pfono/v22n4/en_26x03.jpg align=absmiddle>in all conditions. F2 values for [a] in EC20 and EC30 were significantly lower than values in the other conditions, being closer to the values presented for <img border=0 width=32 height=32 src=/img/revistas/pfono/v22n4/en_26x03.jpg align=absmiddle>. F3 values were not significantly different between the testing conditions. There was a relationship between FN and anti-formants, and the auditory perception of nasality for conditions EC10 and EC20. CONCLUSION: significant changes were observed in the studied spectral values according to changes in the velopharyngeal opening size.TEMA: o controle do tamanho da abertura velofaríngea é uma variável importante na caracterização do perfil acústico da fala hipernasal. OBJETIVO: investigar os aspectos espectrais das frequências de F1, F2, F3, formante nasal(FN) e anti-formante, em Hertz, para as vogais [a] e [ã] na presença de aberturas feitas no bulbo de réplicas da prótese de palato de uma paciente com insuficiência velofaríngea. MÉTODO: gravações de produções de quatro palavras (pato/mato e panto/manto) inseridas em frase veículo foram obtidas em cinco condições de funcionamento velofaríngeo: prótese sem aberturas (condição controle: CC), prótese com abertura de 10mm² no bulbo (condição experimental - CE10), com abertura de 20mm² (condição experimental - CE20), com abertura de 30mm² (condição experimental - CE30), e sem prótese (condição experimental aberta - CEA). Cinco fonoaudiólogos julgaram a nasalidade de fala ao vivo, durante a leitura de um texto oral. As gravações foram usadas para análise espectral. RESULTADOS: valores de F1 foram significativamente mais altos para [a] que para [ã] em todas as condições. Valores de F2 para [a] em CE20 e CE30 foram significantemente mais baixos que nas outras condições, aproximando-se dos valores para [ã]. Valores de F3 não foram significativamente diferentes nas diferentes condições. Houve relação entre os achados de FN e anti-formantes e a percepção de nasalidade para as condições CE10 e CE20. CONCLUSÃO: foram observadas mudanças significativas nos valores espectrais estudados de acordo com alterações no tamanho da abertura velofaríngea.51552

Concordância entre os testes perceptivos e a videofluoroscopia no diagnóstico da disfunção velofaríngea

Objetivo Verificar a concordância entre os resultados dos Testes de Emissão de Ar Nasal e de Hipernasalidade e os achados do exame de videofluorocopia no diagnóstico da disfunção velofaríngea, em indivíduos com fissura labiopalatina. Métodos A amostra foi constituída por 89 exames de videofluoroscopia e 89 escores dos Testes de Emissão de Ar Nasal e de Hipernasalidade, interpretados como fechamento velofaríngeo consistente, ou como fechamento velofaríngeo inconsistente, ou ainda, como não fechamento velofaríngeo. Foram calculadas a sensibilidade, a especificidade e a concordância entre a interpretação dos achados dos testes perceptivos e os achados da videofluoroscopia. Resultados Foram encontrados índices de sensibilidade e especificidade de 98% e 37%, respectivamente, para o Teste de Emissão de Ar Nasal e de 96% e 63%, respectivamente, para o Teste de Hipernasalidade. As porcentagens de concordância entre os escores do Teste de Emissão de Ar Nasal e os exames de videofluoroscopia e entre os escores do Teste de Hipernasalidade e os exames de videofluoroscopia, para a categoria fechamento velofaríngeo consistente, foram de 62% e 70%, respectivamente, de 43% e 47%, para a de fechamento velofaríngeo inconsistente, respectivamente, e de 68% e 77%, para a de não fechamento velofaríngeo, respectivamente. Conclusão Houve um bom nível de concordância entre os testes perceptivos e os exames de videofluoroscopia para as categorias fechamento velofaríngeo consistente e não fechamento velofaríngeo, mas não para a de fechamento velofaríngeo inconsistente