11/48. Alternative impression technique for a speech-aid prosthesis.OBJECTIVE: Prosthetic treatment for speech disorders attributable to surgically acquired soft palate defects are introduced. CASE: A patient who underwent soft palate resection for cancer is presented. The resected portion of the soft palate was confined to the posterior segments. A prosthesis with a speech bulb was adapted to the patient. CONCLUSION: Excellent restoration of speech and improvement of velopharyngeal function was achieved following placement of the special prosthesis.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
12/48. An evaluation of continuous positive airway pressure (CPAP) therapy in the treatment of hypernasality following traumatic brain injury: a report of 3 cases.OBJECTIVE: To evaluate the effectiveness of continuous positive airway pressure (CPAP) therapy in the treatment of hypernasality following traumatic brain injury (TBI). DESIGN: An A-B-A experimental research design. Assessments were conducted prior to commencement of the program, midway, immediately posttreatment, and 1 month after completion of the CPAP therapy program. PARTICIPANTS: Three adults with dysarthria and moderate to severe hypernasality subsequent to TBI. OUTCOME MEASURES: Perceptual evaluation using the Frenchay dysarthria Assessment, the Assessment of Intelligibility of Dysarthric Speech, and a speech sample analysis, and instrumental evaluation using the Nasometer. RESULTS: Between assessment periods, varying degrees of improvement in hypernasality and sentence intelligibility were noted. At the 1-month post-CPAP assessment, all 3 participants demonstrated reduced nasalance values, and 2 exhibited increased sentence intelligibility. CONCLUSIONS: CPAP may be a valuable treatment of impaired velopharyngeal function in the TBI population.- - - - - - - - - - ranking = 0.14285714285714keywords = speech (Clic here for more details about this article) |
13/48. Restoration of intelligible speech 13 years post-head injury.This case study demonstrates the efficacy of treatment of a patient with severe dysarthria long after the accepted period of 'neurological recovery'. A physiological approach to treatment was utilized and resulted in a change from non-verbal communication to functional verbal communication.- - - - - - - - - - ranking = 0.57142857142857keywords = speech (Clic here for more details about this article) |
14/48. Velocardiofacial syndrome with single central incisor.Three siblings and their mother are reported who all had cytogenetically proven velocardiofacial syndrome (VCFS). One boy had normal dental and craniofacial findings, except for an increased cranial base angle. His sister had only one central incisor in the maxilla. One central incisor had also been missing in the primary dentition. She had no labial frenulum present. cephalometry showed a small maxillary unit length indicating mild maxillary hypoplasia, an increased anterior face height, steep mandibular plane angle, retruded chin, and a large cranial base angle. Dental measurements showed retroclined lower incisors and increased interincisal angle. A second sister had a cleft of the secondary palate. All permanent teeth were present with the exception of a missing central incisor in the lower jaw: the single lower central incisor was situated in the midline. Her cephalometry showed similar findings as in her sister. All three siblings required palate surgery for speech. Mother was not available for detailed dental and other oral investigations. A single maxillary central incisor has previously been reported in VCFS, but to our knowledge a single central incisor in the mandible has not been reported previously in this entity.- - - - - - - - - - ranking = 0.14285714285714keywords = speech (Clic here for more details about this article) |
15/48. Instrumental assessment and treatment of hypernasality, following maxillofacial surgery, using SNORS: a single case study.The super nasal oral ratiometry system (SNORS) is a commercially available system which measures both nasal and oral airflow during speech, allowing the very rapid movement of the velum to be measured. SNORS uses a modified oxygen mask, which houses the airflow sensors and microphones, and a standard personal computer. By calculating nasalance (the percentage of airflow that is nasal), an estimation of velopharyngeal closure, which is independent of speech intensity, is achieved. SNORS can be used for objective assessment, where the subject is required to speak a number of words selected to demonstrate velopharyngeal function. SNORS also provides biofeedback, using a simple realtime display of nasal and oral airflow. velopharyngeal insufficiency (VPI) is the inability to make adequate velpharyngeal closure, and may be the result of either neurological or, as in this case, structural abnormalities. It results in abnormal speech characteristics, such as omissions, substitutions or weak articulation of consonants, and hypernasality. T.W., a 52 year old male, had very hypernasal speech following extensive maxillofacial surgery, for the removal of a tonsillar carcinoma. SNORS was successfully used as both an assessment and a therapy tool in the treatment of this patient. The effectiveness of conventional speech and language therapy vs. SNORS biofeedback therapy was compared. Initially, while there was some movement of the velum, the patient could not achieve velopharyngeal closure. Conventional therapy aimed to strengthen and improve the function of the velum and following this there was some minimal improvement: the patient could now achieve, but not maintain, closure. Reassessment, following a non-treatment period, showed little further change. SNORS biofeedback therapy was then given. This raised the patient's awareness of his velopharyngeal function, thus helping him to maintain closure, thereby reducing hypernasality. SNORS therapy proved significantly more effective than conventional speech and language therapy, in this case. Further intervention is outlined, and the benefits of multiparameter assessment of speech are discussed.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
16/48. Velopharyngeal dysfunction: speech characteristics, variable etiologies, evaluation techniques, and differential treatments.This tutorial addresses the complex pathophysiology; various structural and neurologic causes; methods of clinical appraisal; and alternative behavioral prosthetic, and medicosurgical treatments of velopharyngeal dysfunction. To balance the primary focus of this review on hypernasal resonance and articulation disorders, discussions concerning hyponasal speech characteristics and underlying etiologies are also rendered.- - - - - - - - - - ranking = 0.71428571428571keywords = speech (Clic here for more details about this article) |
17/48. Collaboration of a dentist and speech-language pathologist in the rehabilitation of a stroke patient with dysarthria: a case study.OBJECTIVE: To elucidate the effectiveness of the collaboration of a dentist and speech-language pathologist (SLP) in the rehabilitation of a stroke patient with dysarthria. DESIGN: A clinical case report treated in the rehabilitation hospital and dental surgery. SUBJECT: A 71-year-old Japanese man who was admitted to the rehabilitation hospital for speech rehabilitation 2 years and 5 months after a stroke. methods: Provision of prosthesis (palatal lift prosthesis palatal augmentation prosthesis) for improving velopharyngeal incompetence (VPI) and articulation by dentist, and speech behavioural management by SLP including self-monitoring and bio-feedback training using the See-Scape. RESULTS: Speech behavioural management proved useful for promoting improvement in speech intelligibility to a functionally sufficient level after improving VPI by prosthesis. CONCLUSION: The collaborative efforts of the dentist and SLP in the rehabilitation of post-stroke patients with velopharyngeal incompetence should be encouraged.- - - - - - - - - - ranking = 1.1428571428571keywords = speech (Clic here for more details about this article) |
18/48. Postsurgical use of prosthetic palatal appliances. Two case reports.patients with cleft lip or palate encounter a myriad of difficulties in their early years of life, some of which begin at birth. The defect often impairs suckling and deglutition in the neonate. It can hinder appropriate speech development and may impose undue social and psychological stresses. Surgical and orthodontic interventions are essential and prosthetic palatal appliances play an important role not only throughout the patient's treatment course, but also in the treatment of unfavorable surgical sequelae.- - - - - - - - - - ranking = 0.14285714285714keywords = speech (Clic here for more details about this article) |
19/48. Autologous costochondral cartilage implant in two cases of velopharyngeal insufficiency.The velopharyngeal sphincter is critical in enabling the functions of speaking and swallowing. velopharyngeal insufficiency (VPI) results in hypernasal speech and nasal regurgitation. A frequent cause of VPI is congenital cleft palate, but otolaryngologists sometimes encounter iatrogenic VPI after surgery. Treatment of VPI with prostheses is often successful but not always well tolerated. Many surgical procedures have been proposed to correct palatal length or to enlarge the posterior pharyngeal wall. We report two cases in which autologous costochondral cartilage was used as implant augmentation. This approach is indicated and efficient when the velopharyngeal deficit is less than 5 mm. An autologous costochondral cartilage implant procedure is safe and reversible and can be expected to incite minimal host reaction.- - - - - - - - - - ranking = 0.14285714285714keywords = speech (Clic here for more details about this article) |
20/48. Fabrication of a meatus obturator on a titanium framework with a 1-step impression.The fabrication of meatal obturator prosthesis with titanium framework using a 1-step final impression procedure is described in the case of a 44-year-old woman with congenital absence of the soft palate. The meatus obturator results in a more stable maxillary prosthesis and permits acceptable speech for a patient with total absence of the soft palate. The fabrication technique is relatively easy and saves time by eliminating some laboratory procedures.- - - - - - - - - - ranking = 0.14285714285714keywords = speech (Clic here for more details about this article) |
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