舌系带过短对儿童语音的影响

目的 探讨舌系带过短对儿童语音的影响。方法 采用计算机语音信号分析系统及录音判 听的方式对２４例正常及舌系带过短儿童的／ａ／／ｉ／／ｕ／元音语图高频区额外峰的出现率及辅音音节的误念率进行对比分析。结果 舌系带过短儿童在前高元音／ｉ／的高频区有显示的额外峰出现,且辅音误念率较正常儿童组明显偏高。结论 舌系带过短会导致儿童发音方式及发音部位的异常,因此对舌系带过短儿童应尽早手术纠正。     

颞肌瓣修复上颌骨及腭部缺损的语音功能评价

目的　分析颞肌瓣即刻修复上颌骨及腭部术后缺损患者的语音功能恢复情况。方法　通过对 19例应用颞肌瓣修复上颌骨及腭部缺损的患者进行腭咽闭合功能、头颅腭咽侧位X线片测量和语音清晰度测定 ,分析评价颞肌瓣即刻修复上颌骨及软腭部术后缺损患者的语音功能恢复情况。结果　 19例患者中 ,有 15例 (78.0 0 % )为完全腭咽闭合 ,3例 (15 80 % )为边缘性腭咽闭合 ,1例 (5 2 6 % )为腭咽闭合不全 ,平均语音清晰度为 94 3% ,接近正常人语音清晰水平。结论　颞肌瓣修复上颌骨及腭部缺损能够较好地重建口腔发音结构 ,维持腭部功能 ,较好地恢复术后语音功能     

腭裂术后功能性语音不清分类的初步研究

腭裂修复术后恢复了正常腭咽闭合功能，仍有部分患者存在不同程度语音障碍，需行语音训练治疗，而语音治疗的方法需根据发音器官存在的不同问题来决定。我们对１１０例腭裂术后语音不清患者进行腭咽功能等主客观检查评价，选出其中５０例腭咽功能正常，语音清晰度在７０％以下患者进行汉语发音语音学、语音病理学分析研究，并将其分为三类发音异常，即Ｉ类：发音部位异常，占５０例患者的２０％；ＩＩ类：发音方式异常，占２４％；Ｉ     

腭化构音语音训练方法的初步探讨

目的 通过对10名腭名化构音患者语音训练前后语音清晰度的变化,初步探讨腭化构音的训练方法。方法 腭化构音患者10名,年龄4－14岁（平均9．7岁）;其中腭裂术后腭咽闭合功能恢复良好患者4名,无器质性病变的功能性患者6名。所有患者在医师指导下进行系统、循序渐进的语音训练,并在治疗前后分别行语音清晰度检查。结果 腭化构音患者语音治疗后语音清晰度较治疗前显著提高。结果 腭化构音是构音器官异常运动所产生的异常语音,并使语音清晰度降低,需通过语音训练重建正确的发音部位和发音方法。而腭化构音训练的关键在于平展舌体和解除习惯性舌后缩。     

舌系带过短及其诊治方法的研究进展

舌系带过短是一种先天性发育异常,表现为舌系带短粗,与舌腹或口底黏膜的附着点前移,使得舌的运动受限.舌系带过短不同程度地影响了舌的运动,从而可能影响母乳喂养和舌体的吞咽、语音、口腔自洁功能,以及导致开牙合、下中切牙间缝隙等错牙合畸形.其中,舌系带过短对婴幼儿母乳喂养及语音功能的影响,是诊治过程中备受关注、争议较多的热点....     

腭部肿瘤术后洞穿性缺损赝复体修复的语音功能评价

目的评价腭部肿瘤切除术后采用赝复体修复腭部洞穿性缺损对患者术后语音功能的影响。方法选择2009年9月至2011年2月在深圳市人民医院口腔外科因肿瘤切除导致腭部洞穿性缺损的15例患者为研究对象,术后3个月运用赝复体修复腭部洞穿性缺损;另选15名正常人作为对照组。采用主观语音清晰度测试法评价患者佩戴赝复体修复前、后的语音清晰度,对所收集资料进行单因素方差分析。结果患者佩戴赝复体修复前、佩戴赝复体修复后和正常对照组的语音清晰度平均测定值分别为(55.6±1.31)%、(86.9±1.08)%和(98.9±0.51)%,单因素方差分析两两比较结果显示,佩戴赝复体修复后语音清晰度显著高于佩戴赝复体修复前(P<0.01),但仍显著低于正常对照组的语音清晰度(P<0.01)。结论腭部肿瘤术后洞穿性缺损赝复体修复能显著改善患者语音清晰度,但仍须进一步提高。     

辅音/n/和/l/异常语音的特点及其治疗

目的:了解功能性语音障碍辅音/n/、/l/异常的发音特点及对语音清晰度的影响,探讨异常语音的治疗方法。方法:采用主观判听和语音检测方式对16例发/n/、/l/辅音及与之相关的单字、词组、句子发音异常的患者进行汉语语音学、语音病理学分析研究,采用以汉语发音为基础的矫治训练方法对16例患者进行系统的语音训练治疗,并对治疗前后的语音清晰度及辅音清晰度比较进行统计学处理。结果:患者治疗前后的语音清晰度由治疗前的75.8%,提高到治疗后的98.8%。与/n/、/l/有关的辅音清晰度从治疗前的45%提高到98.1%,语音治疗效果良好。结论:系统语音治疗可有效矫正辅音/n/、/l/发音异常的不良习惯,建立正确的发音模式,提高语音清晰度。     

树脂基托、钛基托全口义齿戴用前后语音效果的对比研究

目的对全口义齿初戴前后的临床语音适应效果做出主观评价。方法以患者自评和语音专业人员共同评价汉语语音清晰度的方法,分析30例全牙列缺失患者在义齿初戴前、初戴时、初戴后1、2、4、8周的语音变化规律。结果全口义齿初戴时,两实验组均感觉发音不适,初戴1周后,金属基托组已感觉能适应义齿,塑料基托组需2周以上时间。语音清晰度测评显示,义齿初戴后1周,两组之间有显著性差异(P<0.05),此时金属基托组已显示与初戴前有非常显著差异(P<0.01),塑料基托组需2周以上时间。结论减少全口义齿基托厚度,重建腭皱形态,有助于牙列缺失患者语音功能的恢复,其语音清晰度值较高。     

语音训练在腭裂术后患者语音恢复中的价值

为探讨语音训练在腭裂术后患者语音恢复中的作用，本研究应用计算机语音信号分析系统对经语音训练的２６例腭裂术后患者进行单元音头三个共振峰频率测试，语音训练重点对唇的协调性，舌的灵活性及下颌运动的准确性训练。结果表明，腭咽闭合完全者经语音训练代偿性不良习惯已基本矫正，语音清晰度显著提高。本文提出腭裂术后患者必须在腭咽闭合的基础上，语音训练才能打破异常的神经－肌肉模式，矫正代偿性不良发音习惯、获得清晰准确     

全口义齿基托对语音功能的影响

全牙列缺失患者配戴全口义齿后语音常会发生不同程度的改变，其中上颌基托是影响发音的主要结构。在上颌义齿基托前部重建“S状隆起”，并在正常切牙乳头相应部位的基托上形成一个乳头状的突起将有助于正确发音，在前腭区重建腭皱将有助于辅音的形成，且可缩短患者戴义齿后语音适应的时间。该区作为影响发育的敏感区，加厚基托将影响语音清晰度，在保证固位和强度的前提下，基托不宜过长过厚，为避免影响义齿强度可用腭部金属基托修复。新义齿初戴时约55.2%患者自觉发音障碍，以后在一周到一个月内语音功能逐渐恢复，但其改善有一定的限度。     

强化性语音训练在腭裂术后语音治疗中的应用

目的：采用强化性针对性语音训练以期缩短音训练治疗时间。方法：采用发音部位及发音方式异常针对性语音训练方法,声门停顿音矫治训练方法对患者进行每天１～２次训练,以能发对所有汉语辅音、音节、词组及短句为标准决定训练完成时间。结果：１６名患者经过平均２５ｄ的强化训练后,语音清晰度从平均４９．９％提高到平均８８．２％。平均提高３８．５％。统计学检查有极显著差异性（Ｐ＜０．００１）。结论：强化性针对性语音训练确能在较短时间内达到提高语音清晰度,改善语音功能的目的。     

不同舌重建术后患者语音功能的评价

目的:评价不同舌重建术式对舌癌患者术后语音功能恢复的影响。方法:32例舌癌患者据重建术式分组:带蒂胸大肌肌皮瓣修复组5人,除1例外舌切除缘范围均过中线;前臂游离皮瓣修复组和邻近组织瓣修复组分别为16人和11人,除1例外舌切除缘范围均不过中线。采用汉语语音清晰度测试和短句测试方法,对患者手术前后语音清晰度变化情况进行分析,并对前臂游离皮瓣修复组和邻近组织瓣修复组的评价结果进行团体t检验。结果:带蒂胸大肌肌皮瓣修复组、前臂游离皮瓣修复组和邻近组织瓣修复组术后的语音清晰度平均下降值分别为26.60、7.84和4.18分,短句测试得分下降值分别为1.60、0.50和0.27分;t检验结果显示,前臂皮瓣和邻近组织瓣修复组的语音清晰度和短句测试得分下降值间无显著性差异(P>0.05)。结论:舌癌手术切除后运用前臂游离皮瓣或邻近组织瓣进行舌重建均能较好地恢复患者术后的语音功能,且两者间没有显著差异;对于舌缺损范围较大尤其是超过半侧舌的患者,采用带蒂胸大肌皮瓣也能够在一定程度上改善患者术后的语音功能。     

不同年龄组咽成形术后异常语音治疗的效果

目的通过对不同年龄组咽成形术后异常语音治疗效果的分析,为病理语音治疗年龄选择提供参考。方法选取271例咽成形术后进行异常语音治疗的患者（4~25岁）,按年龄分为4组: 幼儿（4~6岁）、儿童（7~12岁）、少年（13~17岁）和青年（18~25岁）。所有患者均按腭咽闭合功能、音素、音节、短句进行系统性语音训练。用清晰度测试表对治疗前后语音清晰度和过度鼻音进行检测,采用SPSS 16.0软件包对各年龄组治疗前、后的上述2个指标进行统计学分析。结果271例患者中,幼儿组62例、儿童组59例、少年组43例、青年组107例。各组治疗前、后语音清晰度分别为幼儿组（35.91%、98.22%）、儿童组（38.11%、98.63%）、少年组（45.59%、98.51%）和青年组（39.78%、98.21%）;每组治疗前、后语音清晰度均有显著差异,各组治疗后语音清晰度均无显著差异。各组治疗前、后过度鼻音改善,改善率分别为幼儿组70.97%,儿童组62.71%,少年组44.19%和青年组43.93%;各组治疗后过度鼻音改善均存在显著差异。结论咽成形术后异常语音治疗后语音清晰度与年龄大小无关;而过度鼻音改善程度与年龄大小有关,年龄越小,改善程度越高。     

A four-year longitudinal study of palatal plate therapy in children with Down syndrome: effects on oral motor function,articulation and communication preferences

The orofacial function in 20 children with Down syndrome was evaluated after 4 years of palatal plate therapy in 9 of the children (PPG); the remaining 11 were untreated age-matched controls (CG). All 20 children had received continuous orofacial physical therapy from their speech therapist during the treatment period. A clinical extra- and intraoral examination was performed, including oral motor function, facial expression, the occurrence of malocclusions, and hypertrophic tonsils. A questionnaire requesting data on breathing patterns, drooling, eating problems, and communicative preferences was answered by the parents. An articulation assessment was performed by two speech and language pathologists blinded to the treatment status of the children in order to find out whether the palatal plate had stimulated to improved oral speech behavior. The results for oral motor function showed significant differences between the groups in favor of the PPG for the summary variables for: visible tongue (P < 0.01), visible tongue during non-speech periods (P < 0.05), and lip-rounding during spontaneous speech (P < 0.01). During non-speech time, the PPG had their mouths open significantly less than the CG (P < 0.05). Expressivity of facial expression on a visual analog scale in the PPG scored 75.6 ± 13.3 compared to 51.8 ± 25.7 in the CG (P < 0.05). The intraoral examination showed that 6/9 children in the PPG and 7/11 in the CG had enlarged tonsils, resulting in more than 50% inter-tonsillary space reduction. Despite these findings, and no significant differences between the groups with respect to mouth/nose breathing, nocturnal snoring was significantly less in the PPG than in the CG (P < 0.05), according to the parental questionnaire. After 4 years of palatal plate therapy, orofacial function had improved significantly in the 9 PPG children and specifically in terms of tongue position and lip activity.     

腭裂咽成形术后患者语音治疗疗效评价

目的:对腭咽成形术后存在语音障碍的患者进行语音治疗,通过治疗前后语音清晰度比较,评价该方法的疗效。方法:咽成形术后患者82例,年龄4~31岁。采用汉语语音清晰度测试表对患者进行治疗前后语音清晰度检测,根据代偿性发音特点进行系统化语音训练:①腭咽闭合功能锻炼;②音素→音节→词组→短句→短文、会话。训练时按发音部位由前→后,按发音方法由易→难、送气音→不送气音、塞音→擦音→塞擦音。训练周期1.5~12个月,平均3.83个月。结果:以腭咽闭合不全型为特点的代偿性语音患者共71例;其中声门塞音患者语音清晰度由治疗前的46.27%提高到治疗后的97.16%;咽摩擦音患者由治疗前的57.19%提高到治疗后的97.72%。以腭咽闭合良好型为特点的代偿性语音共11例,腭化、侧化音患者语音清晰度由治疗前的71.10%提高到治疗后的98.55%;3组经t检验,P均<0.001,具有极显著性差异。结论:对咽成形术后腭咽闭合不全型的代偿性发音,首先加强腭咽闭合功能,再建立正确的发音部位和方法;对咽成形术后腭咽闭合良好型的代偿性发音,可直接建立正确的发音部位和方法。     

Impact of anterior single-tooth implants on quality of life, articulation and oromyofunctional behaviour: a pilot study

The main purpose of this study is to determine the impact (one and a half year after implantation) of a single-tooth implant on articulation and oromyofunctional behaviour. This information is important for dentists, orthodontists or stomatologists who treat professional speakers. Objective (acoustic analysis) as well as subjective (questionnaire, phonetic inventory, phonetic analysis, oromyofunctional assessment of lip and tongue function, blowing, sucking and swallowing) assessment techniques were used to determine the quality of life, articulation and oromyofunctional behaviour. Fourteen subjects who received a single-tooth implant and a control group of nine subjects participated in this study. The mean overall satisfaction of single-implant users was 95%. The subjects who received a single-tooth implant were capable of producing all Dutch vowels and consonants. The phonetic analysis revealed a sigmatism in 57% of the cases. Sigmatisms (stridens sigmatism followed by simplex sigmatism) were the most frequently observed phonetic disorders. There was interobserver agreement about normal lip and tongue functions. Moreover, blowing, sucking and swallowing patterns were normal (concordance value 96%). Detailed analyses 1 or 2 years after implantation of an anterior single-tooth implant revealed normal speech intelligibility and oromyofunctional behaviour. Articulation was characterised by the presence of a persistent phonetic disorder. Further research involving more subjects with an anterior single-tooth implant is needed.     

应用Z成形术矫正舌系带过短38例报告

应用Z成形术治疗舌系带过短38例取得满意疗效其中男22例,女16例,手术年龄6个月～6岁。术后无感染、伤口裂开、舌黏连等并发症,伤口愈合快,舌体运动正常,术后1周检查舌前伸由术前的13．5mm增加到术后24．6mm,上举由术前的4．8mm增加到术后20．6mm。     

腭咽阻塞器在腭裂术后腭咽闭合不全语音障碍中的治疗作用

目的 :探讨腭咽阻塞器对腭裂术后腭咽闭合不全 (VPI)的语音功能障碍的治疗作用。方法 :应用腭咽阻塞器治疗腭裂术后VPI患者 13 5例 ,分别于治疗前 ,治疗后 180d、1年、2年 ,观察VPI患者的腭咽闭合不全率 (RVPI)、腭咽闭合不全改善率 (IRVPI)、各单元音共振峰频率F3以及语音效果的变化。结果 :腭咽阻塞器治疗后 ,VPI患者的RVPI逐渐降低 ,IRVPI逐渐增高 ,且各单元音共振峰F3逐渐增高 ,接近正常人 ,与治疗前比较差异有显著性 (P <0 .0 1)。去除阻塞器后 ,45例患者腭咽闭合正常 ,语音恢复正常 ,45例患者腭咽闭合基本正常 ,语音基本正常。结论 :腭咽阻塞器治疗腭咽闭合不全具有恢复语音功能的作用     

Effect of varying bulb height on articulation and nasalance in maxillectomy patients with hollow bulb obturator

PurposeTo evaluate the effect of bulb height of hollow bulb obturator prosthesis on articulation and nasalance.MethodA total of 10 patients, who were to undergo maxillectomy falling under Aramany class-I and II, with normal speech and hearing pattern were selected for the study. They were provided 2 maxillary obturators, one extending full height of the defect and other with bulb height approximately up to inferior nasal concha. The patients were asked to wear each obturator for 6 weeks and the speech analysis was done to measure changes in articulation and nasalance at 6 different stages of treatment i.e. preoperative, postoperative (after complete healing), 24 h and 6 weeks after providing full bulb height obturator and reduced bulb height obturator. Articulation was measured objectively for distortion, addition, substitution and omission by speech pathologist and nasalance was measured by Dr. SPEECH software.ResultComparison between full and reduced bulb height for nasalance and articulation, showed that there was no statistical significant difference (P > 0.05) between the two for both the parametres.ConclusionArticulation and nasality improves after providing obturator. Articulation and nasalance both are independent of bulb height.