1/17. Effect of bilateral subthalamic nucleus stimulation and dopatherapy on oral control in Parkinson's disease.This study focuses on the speech organs of a parkinsonian patient who initially had been treated with levodopa for 13 years, and had become severely disabled by motor fluctuations. This patient has been treated with bilateral chronic stimulation of the subthalamic nucleus (STN) for the last 2 years. Upper lip, lower lip and tongue force production were examined before surgery under off and on medication conditions, and 2 years after surgery under off and on stimulation conditions. We compared the effect of stimulation and dopatherapy on the speech organs. L-Dopa had a poor effect whereas bilateral stimulation improved oral control and speech intelligibility. These results suggest that STN stimulation influences speech organs in a different way from the dopaminergic system and similarly affects oral and limb motor systems.- - - - - - - - - - ranking = 1keywords = tongue (Clic here for more details about this article) |
2/17. dysarthria as the isolated clinical symptom of borreliosis--a case report.This report presents a case of dysarthria due to hypoglossal nerve mono-neuropathy as the only consequence of neuroborreliosis. The 65-year-old man with a seven-months history of articulation disturbances was examined. The speech of the patient was slow and laboured. A slight weakness of the muscles of the tongue (left-side) was observed. The patient suffered from meningitis due to borrelia burgdorferi infection in 1999 and initially underwent a successful antibiotic treatment. Detailed radiological investigation and psychological tests were performed and co-existing neurological diseases were excluded. To describe profile of speech abnormalities the dysarthria scale was designed based on S. J. Robertson dysarthria Profile. There were a few disturbances found in self-assessment of speech, intelligibility, articulation, and prosody but especially in the morphology of the articulation muscles, diadochokinesis, the reflexes (in the mouth, larynx and pharynx). Needle EMG examination confirmed the diagnosis of mono-neuropathy of left hypoglossal nerve. The study confirms the fact that neuroborreliosis may evoke chronic consequences.- - - - - - - - - - ranking = 1keywords = tongue (Clic here for more details about this article) |
3/17. Minimally invasive functional reconstruction after extended oropharyngeal resection including soft palate and base of tongue using a pectoralis major myocutaneous flap.Excision of large oropharyngeal carcinomas that affect the base of the tongue and the soft palate severely impairs swallowing and articulation. In the present study we describe a minimally invasive technique that effectively restores swallowing and articulation by the insertion of a pectoralis major myocutaneous flap with a bilobular skin island. One lobe of the skin island is used to reconstruct the base of the tongue and the other to reconstruct the oropharynx. The soft palate is reconstructed by folding the tip of the lobe that is used to reconstruct the oropharynx in half along the long axis to fill the rhinopharynx. We have done this procedure for 13 patients with oropharyngeal carcinoma. Six months postoperatively all 13 were able to swallow without aspiration. Nine of the 13 patients were able to hold a normal conversation, but the remaining four had severe rhinolalia aperta. However, this condition was easily corrected by secondary reconstruction using a pharyngeal flap and a palatal mucoperiosteal flap (n = 3) or by the use of a small speech aid (n = 1).- - - - - - - - - - ranking = 6keywords = tongue (Clic here for more details about this article) |
4/17. Changes in linguapalatal contact patterns during therapy for velar fronting in a 10-year-old with Down's syndrome.BACKGROUND: Articulation errors in the speech of people with Down's syndrome are frequent and often resistant to speech therapy. This preliminary study investigates the use of electropalatography (EPG) to diagnose and treat abnormal articulation patterns associated with velar fronting in a 10-year-old girl. AIMS: The study measured changes in the accuracy and stability of linguapalatal (tongue-palate) contact patterns during a 14-week course of visual feedback therapy using EPG. Therapy aimed to resolve a pattern of velar fronting whereby targets /k, g, eta/ had alveolar placement [t, d, n]. methods & PROCEDURES: The participant was a girl (P) with Down's syndrome aged 10;11 years. P had a moderate-severe speech disorder, which included velar fronting. Her speech was recorded with EPG on three occasions during a 14-week course of therapy: first, before therapy; second, midway through therapy; and third, after therapy. Three analyses were conducted on the EPG data. The first used an EPG classification scheme that identified accuracy of placement for /t/ and /k/ targets. The second was a centre of gravity measure that detected whether P produced a significant difference between /t/ and /k/ targets. The third was a variability index that quantified the stability of contact patterns. OUTCOMES & RESULTS: The results of the EPG classification showed that before therapy, /t/ and /k/ targets had identical alveolar placement, reflecting the process of velar fronting. The results after therapy showed that 87% of /k/ targets had accurate velar placement. The centre of gravity measure showed no difference in contact patterns for /t/ and /k/ before therapy, but a statistically significant difference at the second and third recordings. The variability index showed stable contact patterns before therapy for /t/ and /k/ targets, but both became highly unstable midway through therapy, with a return to stability at the third recording. We embed a discussion of P's increased articulation instability during therapy in a recent theoretical framework--dynamic systems--that attempts to account for the emergence of new behavioural forms. CONCLUSIONS: These preliminary results suggest that EPG has potential as an effective diagnostic and therapy procedure for articulation errors in people with Down's syndrome. A major issue still to be addressed, however, is the extent to which others will benefit from this approach to intervention.- - - - - - - - - - ranking = 1keywords = tongue (Clic here for more details about this article) |
5/17. Using electropalatography (EPG) to diagnose and treat articulation disorders associated with mild cerebral palsy: a case study.Some children with mild cerebral palsy have articulation disorders that are resistant to conventional speech therapy techniques. This preliminary study investigated the use of electropalatography (EPG) to diagnose and treat a long-standing articulation disorder that had not responded to conventional speech therapy techniques in an 8-year-old boy (D) with a congenital left hemiplegia. The targets for EPG therapy were speech errors affecting velar targets /k, g, eta/, which were consistently fronted to alveolar placement [t, d, n]. After 15 sessions of EPG therapy over a 4-month period, D's ability to produce velars improved significantly. The EPG data revealed two features of diagnostic importance. The first was an unusually asymmetrical pattern of tongue-palate contact and the second was unusually long stop closure durations. These features are interpreted as a subtle form of impaired speech motor control that could be related to a mild residual neurological deficit. The results suggest that EPG is of potential benefit for diagnosing and treating articulation disorders in individuals with mild cerebral palsy.- - - - - - - - - - ranking = 1keywords = tongue (Clic here for more details about this article) |
6/17. macroglossia: a case study.A young child with macroglossia of unknown cause was seen for treatment to modify resting tongue posture and improve speech sound production. Evaluation of the treatments indicated positive change in resting tongue posture and a modest change in speech sound production. Treatment for such patients can be complex and must consider orthodontic and/or surgical interventions, because an enlarged tongue can influence growth, development, and physiology of the oropharyngeal complex. The speech-language pathologist must be prepared to deal with the complex of problems demonstrated by patients with macroglossia during growth and development. learning OUTCOMES: (1) As a result of this activity, the participant will be able to describe the sequelae of macroglossia. (2) As a result of this activity, the participant will be able to identify appropriate treatment options for children with macroglossia.- - - - - - - - - - ranking = 3keywords = tongue (Clic here for more details about this article) |
7/17. Immediate and sustained changes in tongue movement with an experimental palatal "fistula": a case study.OBJECTIVE: To determine the immediate and longer-term effect(s) on tongue movement following the placement of an experimental opening through a palatal obturator (replicate of subject's prosthesis) worn by an adult male with an unrepaired cleft of the hard and soft palate. methods: tongue movements associated with an anterior experimental opening of 20 mm(2) were examined under three conditions: a control condition in which the subject wore the experimental obturator completely occluded, a condition immediately after drilling the experimental openings through the obturator, and a condition after 5 days in which the subject wore the experimental obturator with the experimental opening. An Electromagnetic Articulograph was used for obtaining tongue movements during speech. RESULTS: The findings partly revealed that the immediate introduction of a perturbation to the speech system (experimental fistula) had a temporary effect on tongue movement. After sustained perturbation (for 5 days), the system normalized (going back toward control condition's behavior). Perceptual data were consistent with kinematic tongue movement direction in most of the cases. CONCLUSIONS: Although the immediate response can be interpreted as indicative of the subject's attempts to move the tongue toward the opening to compensate for air loss, the findings following a sustained perturbation indicate that with time, other physiological adjustments (such as respiratory adjustments, for example) may help reestablish the requirements of a pressure-regulating system.- - - - - - - - - - ranking = 9keywords = tongue (Clic here for more details about this article) |
8/17. Effect of a maxillary glossectomy prosthesis on articulation and swallowing.Swallowing was found to be substantially improved with the prosthesis. Less aspiration, less time necessary to complete the swallow, and greater variation in food consistency tolerated were all positive results of the prosthesis. In addition, videofluoroscopic studies of tongue movements during speech revealed that tip-alveolar /t-d/ and back-velar /k-g/ productions were more normal with the prosthesis. With the prosthesis, the understandibility of /t/ and /d/ was improved 20% and that of /k/ and /g/, 33%. It is clear that compromises must be effected in prosthesis design to facilitate improvement in both speech and swallowing. A large prosthetic mass in the oral cavity can also negatively change speech resonance. These issues are being investigated, as are acoustic and perceptual studies of speech articulation. Future research should address whether a combination of maxillary and mandibular prostheses would result in better speech and swallowing function. A mandibular prosthesis could replace missing teeth and alveolar contour that might influence speech and swallowing. A mandibular prosthesis might also allow construction of a smaller maxillary glossectomy prosthesis to interact with the mandibular prosthesis.- - - - - - - - - - ranking = 1keywords = tongue (Clic here for more details about this article) |
9/17. An instrumental phonetic study of lingual activity in articulation-disordered children.Traditional auditory-based assessment procedures for diagnosing articulation disorders are limited in that they provide no direct information on activities of the speech organs. In this study electropalatography (EPG) was used to obtain details of tongue contacts with the hard palate in 4 articulation-disordered children, 2 of whom had been categorized as dysarthric. Their lingual-palatal contact patterns during four repetitions of word lists containing lingual consonants in different phonetic environments, were compared with each other and with a group of normal speakers. EPG provided relevant diagnostic information in that all 4 experimental subjects showed patterns that differed from the normals in both spatial configuration and variability. The nature of their distorted patterns allowed a tentative diagnosis of 2 of the children as verbal dyspraxic.- - - - - - - - - - ranking = 1keywords = tongue (Clic here for more details about this article) |
10/17. The use of a prosthetic speech aid for a laryngectomized esophageal speaker with right hemiparesis of the tongue: a case report.A dental-palatal prosthetic device, which had been demonstrated to aid laryngectomees who use the glossal press method of esophageal speech, was used on a patient whose primary method of air charging was bilabial plosive injection and who had a right hemiparesis of the tongue. Cointervention of a prosthodontist and a speech pathologist is described.- - - - - - - - - - ranking = 5keywords = tongue (Clic here for more details about this article) |
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