Perceptual, nasometric and aerodynamic speech analysis in subjects undergoing pharyngeal flap surgery for velopharyngeal insufficiency / Análise perceptiva, nasométrica e aerodinâmica da fala de indivíduos submetidos à cirurgia de retalho faríngeo para a correção da insuficiência velofaríngea

AUTOR(ES)

Ana Paula Fukushiro

DATA DE PUBLICAÇÃO

2007

RESUMO

Objective: To evaluate the effectiveness of pharyngeal flap surgery (PFS) for the correction of velopharyngeal insufficiency (VPI), by means of speech perceptual and instrumental assessment, and to verify the influence of preoperative hypernasality, age, surgeon and speech therapy on the results. Model: Prospective study on 241 patients with VPI, who underwent PFS at the Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo (HRCA-USP). Setting: Laboratory of Physiology, HRCA-USP. Variables: Hypernasality, assessed by perceptual ratings and by means of nasalance scores provided by nasometry, and velopharyngeal function, assessed perceptually and by means of velopharyngeal orifice area provided by pressure-flow technique, before (1 to 4 days) and after (6 to 48 months) surgery. Results: Reduction of hypernasality and of nasalance scores was observed in 75% and 68% of the cases, and improvement of VP function and area in 67% and 66%, respectively. Smaller proportions were observed by using more rigorous criteria of analysis (elimination/normalization). Greater success rates were observed in patients with mild preoperative hypernasality, as compared to the others (mild>moderate>severe), in children, comparatively to other age groups analyzed (6-12>13-17>18-29>30-57years) and in patients who had concluded postoperative speech therapy, comparatively to those in another situation (concluded>in progress>interrupted). The results did not differ among surgeons. Conclusions: PFS was shown to be effective in the reduction of VPI symptoms for a significant number of patients. Complete resolution was observed in smaller proportion of cases. Preoperative hypernasality, age at surgery and postoperative speech therapy were relevant factors for the treatment success.

ASSUNTO(S)

nasometry insuficiência velofaríngea nasometria pharyngeal flap hipernasalidade técnica fluxo-pressão hypernasality fissura palatina velopharyngeal insufficiency retalho faríngeo pressure-flow technique cleft palate

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