[Voice disorders in children with velopharyngeal valving problems].
The purpose of this study was to examine if velopharyngeal valving problem can affect voice production (phonation) to some extent. Seventeen cleft palate children, mean age 7.0 had developed hoarseness for years without any treatment. In this study, each subject received a complete voice evaluation and the velopharyngeal (VP) function assessment. Voice evaluation included vocal cords condition and four voice parameters (quality, intensity, fundamental frequency and phonation behaviors). V-P function, classified into 3 levels (adequate, marginal & inadequate), was based on speech evaluation and instrumentations. The results showed that 41% of the subject had had bilateral vocal nodules; phonation indicated various findings in four parameters. V-P function indicated 83% of the subjects had valving problems, among which 71% had marginal V-P level. The results lead to discussion that V-P valving problems may be related with phonation disorders, because subjects like to use "compensatory behaviors" to mask their speech disorders. Among the level of valving problems, a marginal V-P function may achieve an appropriate V-P valving under compensatory behaviors and results in phonation disorders. The authors further suggest that subjects with V-P valving problems should not be subjected to the stresses of speech therapy for hypernasality because of the chance that they would compensate laryngeally for V-P problems. Meanwhile, the treatment for nodules or voice disorders should eliminate compensatory behaviors, then secondary management such as pharyngeal flap surgery for V-P problem should be considered if voice disorders persist.
Wang
N M
NM
Department of Otorlaryngology, Plastic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Yeung
K W
KW
Chen
T A
TA
Chen
Y R
YR
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D014681:Velopharyngeal Insufficiency / Q000150:complications*; D014832:Voice Disorders / Q000209:etiology*