Evaluation and Treatment of Resonance Disorders

Resonance disorders can be caused by a variety of structural abnormalities in the resonating chambers for speech, or by velopharyngeal dysfunction. These abnormalities may result in hypernasality, hypo- or denasality, or cul-de-sac resonance. Resonance disorders are commonly seen in patients with craniofacial anomalies, particularly a history of cleft palate. The appropriate evaluation of a resonance disorder includes a speech pathology evaluation, and may require a video-fluoroscopic speech study or nasopharyngoscopy assessment. Treatment may include surgery or the use of prosthetic devices, and usually speech therapy. Given the complexity of these disorders in regard to evaluation and treatment, the patient is best served by an interdisciplinary craniofacial anomaly team.

[1]  Trost Je Articulatory additions to the classical description of the speech of persons with cleft palate. , 1981 .

[2]  J. Riski,et al.  Prosthetic management of neurogenic velopharyngeal incompetency. , 1979, North Carolina dental journal.

[3]  M. A. Witzel,et al.  Patterns and location of velopharyngeal valving problems: atypical findings on video nasopharyngoscopy. , 1989, The Cleft palate journal.

[4]  R. Loney,et al.  Velopharyngeal dysfunction: recommendations for use of nomenclature. , 1987, The Cleft palate journal.

[5]  B. Straatsma COMMUNICATIVE DISORDERS RELATED TO CLEFT LIP AND PALATE , 1973 .

[6]  R. Dalston,et al.  A preliminary investigation concerning the use of nasometry in identifying patients with hyponasality and/or nasal airway impairment. , 1991, Journal of speech and hearing research.

[7]  B. Weinberg,et al.  Prediction of velopharyngeal orifice area: a re-examination of model experimentation. , 1980, The Cleft palate journal.

[8]  D. Kuehn New Therapy for Treating Hypernasal Speech Using Continuous Positive Airway Pressure (CPAP) , 1991, Plastic and reconstructive surgery.

[9]  R. Dalston,et al.  Use of nasometry as a diagnostic tool for identifying patients with velopharyngeal impairment. , 1991, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[10]  Christine H. Shadle,et al.  The Aerodynamics of Speech , 1997 .

[11]  Warren Dw Perci: a method for rating palatal efficiency. , 1979 .

[12]  Witzel Ma,et al.  Patterns and location of velopharyngeal valving problems: atypical findings on video nasopharyngoscopy. , 1989 .

[13]  Trost Je Coming to terms with VPI: a response to Loney and Bloem. , 1989 .

[14]  J. Marsh,et al.  Practical application of flexible fiberoptic nasopharyngoscopy for evaluating velopharyngeal function. , 1988, Plastic and reconstructive surgery.

[15]  F. Darley,et al.  An articulation test for assessing competency of velopharyngeal closure. , 1961, Journal of speech and hearing research.

[16]  R. Netsell,et al.  Prosthetic management and speech improvement in individuals with dysarthria of the palate. , 1970, Journal of the American Dental Association.

[17]  D. W. Warren,et al.  A PRESSURE-FLOW TECHNIQUE FOR MEASURING VELOPHARYNGEAL ORIFICE AREA DURING CONTINUOUS SPEECH. , 1964, The Cleft palate journal.

[18]  Munro Ir,et al.  Velopharyngeal insufficiency after maxillary advancement. , 1977 .

[19]  W. R. Posnick Prosthetic management of palatopharyngeal incompetency for the pediatric patient. , 1977, ASDC journal of dentistry for children.

[20]  M. Skolnick,et al.  The sphincteric mechanism of velopharyngeal closure. , 1973, The Cleft palate journal.

[21]  R. M. Mason,et al.  An Orofacial Examination Checklist , 1977 .

[22]  R. Shprintzen,et al.  Hypernasal speech caused by tonsillar hypertrophy. , 1987, International journal of pediatric otorhinolaryngology.

[23]  D. Billmire,et al.  Hypertrophic tonsils: the effect on resonance and velopharyngeal closure. , 1993, Plastic and reconstructive surgery.

[24]  S. Shott,et al.  Changes in nasal resonance secondary to adenotonsillectomy. , 1993, American journal of otolaryngology.

[25]  B. J. Mcwilliams,et al.  RATINGS OF VELOPHARYNGEAL CLOSURE DURING BLOWING AND SPEECH. , 1965, The Cleft palate journal.

[26]  H. Mccomb,et al.  Cleft lip and palate. , 1973, Australian dental journal.

[27]  K. Moller,et al.  Cleft palate : interdisciplinary issues and treatment , 1993 .

[28]  B. J. Mcwilliams,et al.  Vocal cord abnormalities in children with velopharyngeal valving problems , 1973, The Laryngoscope.

[29]  J. Dworkin,et al.  Management of velopharyngeal incompetence in dysarthria: a historical review. , 1980, Clinical otolaryngology and allied sciences.

[30]  R. Shprintzen,et al.  Selective movement of the lateral aspects of the pharyngeal walls during velopharyngeal closure for speech, blowing, and whistling in normals. , 1975, The Cleft palate journal.

[31]  Peterson-Falzone Sj Velopharyngeal inadequacy in the absence of overt cleft palate. , 1985 .

[32]  N. Lass Handbook of speech-language, pathology, and audiology , 1988 .

[33]  Posnick Wr Prosthetic management of palatopharyngeal incompetency for the pediatric patient. , 1977 .

[34]  Skolnick Ml Videofluoroscopic examination of the velopharyngeal portal during phonation in lateral and base projections--a new technique for studying the mechanics of closure. , 1970 .

[35]  I. Munro,et al.  Velopharyngeal insufficiency after maxillary advancement. , 1977, The Cleft palate journal.

[36]  H. Morris,et al.  Cleft Palate Speech , 1989 .

[37]  J. Pearce Clinical Management of Neurogenic Communicative Disorders , 1986 .

[38]  T. Watterson,et al.  Transnasal Videoendoscopy of the Velopharyngeal Port Mechanism , 1990 .

[39]  A W Kummer,et al.  The effects of Le Fort I osteotomy with maxillary movement on articulation, resonance, and velopharyngeal function. , 1989, The Cleft palate journal.

[40]  G. Georgiade,et al.  A rationale for modifying the site of insertion of the orticochea pharyngoplasty. , 1984, Plastic and reconstructive surgery.

[41]  M. Skolnick,et al.  Videofluoroscopic Studies of Speech in Patients with Cleft Palate , 1989, Springer New York.

[42]  Ronald J. Baken,et al.  Clinical measurement of speech and voice , 1987 .

[43]  H. A. Leeper,et al.  Changes in vocal resonance and nasalization following adenoidectomy in normal children: preliminary findings. , 1991, The Journal of otolaryngology.

[44]  Miguel Ortigochea CONSTRUCTION OF A DYNAMIC MUSCLE SPHINCTER IN CLEFT PALATES , 1968 .

[45]  B. Mccabe,et al.  Teflon® Injection in the Nasopharynx to Improve Velopharyngeal Closure , 1977, The Annals of otology, rhinology, and laryngology.

[46]  Morris Hl,et al.  Oral-pharyngeal movements during swallowing and speech. , 1973 .

[47]  E. Kaplan Cleft Palate and Cleft Lip: A Team Approach to Clinical Management and Rehabilitation of the Patient , 1982 .

[48]  G. Berger,et al.  Peritonsillar Abscess as a Cause of Transient Velopharyngeal Insufficiency , 1993 .

[49]  M. Orticochea Construction of a dynamic muscle sphincter in cleft palates. , 1968, Plastic and reconstructive surgery.

[50]  A. Kummer,et al.  Changes in articulation and resonance after tongue flap closure of palatal fistulas: case reports. , 1989, The Cleft palate journal.

[51]  K. Moll,et al.  Velopharyngeal closure on vowels. , 1962, Journal of speech and hearing research.

[52]  B. J. Mcwilliams,et al.  Diagnostic implications of vocal cord nodules in children with cleft palate , 1969, The Laryngoscope.

[53]  David R. Beukelman,et al.  Clinical Management of Dysarthric Speakers , 1987 .

[54]  J E Trost,et al.  Articulatory additions to the classical description of the speech of persons with cleft palate. , 1981, The Cleft palate journal.

[55]  R. Shprintzen,et al.  Nasopharyngoscopy of the normal velopharyngeal sphincter: an experiment of biofeedback. , 1982, The Cleft palate journal.

[56]  A. Kummer,et al.  Comparison of velopharyngeal gap size in patients with hypernasality, hypernasality and nasal emission, or nasal turbulence (rustle) as the primary speech characteristic. , 1992, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[57]  I. Jackson,et al.  The sphincter pharyngoplasty as a secondary procedure in cleft palates. , 1977, Plastic and reconstructive surgery.