语音训练对改善轻度腭咽闭合不全患者发音的研究

目的研究语音训练对轻度腭咽闭合不全（VPI）患者发音的影响。方法选择经咽腔造影检查显示的腭咽部间隙为1～5 mm并且经语音评估诊断为轻度VPI的患者30例设为VPI组,均为在四川大学华西口腔医院唇腭裂外科行腭帆提肌重建术的非综合征型腭裂复诊患者,均于术后进行了3～6个月的语音训练。采用VS-99语音频谱分析系统测定患者在语音训练前和训练后发［i］音时第2、3共振峰的数值F2、F3,并与30例对照组（C组）的测定结果进行比较。结果VPI组语音训练前的F2、F3分别为（1 958.95±431.40）、（3 059.84±330.09）Hz,训练后分别为（2 322.95±213.02）、（3 293.84±215.08）Hz;C组的F2、F3分别为（2 430.47±223.05）、（3 345.97±180.83）Hz。VPI组语音训练前与C组的差异有统计学意义（P<0.05）,语音训练后与C组的差异无统计学意义（P＞0.05）;语音训练前后VPI组组内比较的差异有统计学意义（P<0.05）,语音训练后高于训练前。结论对于年龄很大才进行腭裂修复的患者,建议术后先实施语音训练,能显著改善腭咽闭合不全,有可能避免再次手术。

Effects of speech training on velopharyngeal insufficiency in patients with cleft palate

Objective To investigate the effects of speech training on velopharyngeal insufficiency（VPI） in patients with cleft palate. Methods Classify 30 non -syndrome cleft palate patients into Group VPI who was performed levator veli palatini reconstruction surgery at Department of Cleft and Palate Surgery, West China College of Stomatology, Sichuan University and who was performed speech training for 3-6 months after surgery. These patients were diagnosed as mild VPI by speech estimation and demonstrated a velopharyngeal distance between 1 and 5 mm through photography of pharyngeal cavity. VS-99 audio frequency analyzing system was applied to measure the second （F2） and third formant（F3） frequency of vowel i] of 30 VPI patients before and after speech training, obtained data was compared with those of 30 normal people（Group C）. Results The formant frequency of Group VPI before speech training was F2（1 958.95±431.40）Hz and F3（3 059.84±330.09）Hz. The formant frequency of Group VPI after speech training was F2（2 322.95±213.02）Hz and F3（3 293.84±215.08）Hz. The formant frequency of Group C was F2（2 430.47±223.05）Hz and F3（3 345.97±180.83）Hz. The comparison of F2 and F3 between Group C and Group VPI before speech training showed significant difference（P<0.05）. The comparison of F2 and F3 between Group C and Group VPI after speech training showed no significant difference（P＞0.05）. The comparison of F2 and F3 before and after the speech training in Group VPI showed significant difference（P<0.05）, in which data was higher after speech training. Conclusion Speech training is first recommended for those patients who received the cleft palate surgery at an elder age. It can improve the velopharyngeal insufficiency significantly, which may eventually keep the patients away from a second surgery.