title: Pressure-flow measurements for selected oral sound segments produced by normal children and adolescents: a basis for clinical testing.
abstract: Despite advances in surgery, a significant number of patients who undergo cleft palate repair have residual velopharyngeal insufficiency. Maxillary advancement may also result in velopharyngeal openings during speech. Instrumental approaches providing objective measures of palatal function assisting in the accurate diagnosis of these patients include pressure-flow measurements of velopharyngeal valving during speech. There is little information to guide clinicians in interpreting pressure-flow data when testing pediatric patients, however. The primary purpose of this study was to develop a method for categorizing pressure-flow data used in the diagnosis of children and adolescents with suspected velopharyngeal insufficiency. This prospective study involved 56 male and female subjects 5 to 18 years of age. Subjects had normal speech and resonance at the time of testing, no history of speech therapy, no upper respiratory infections or allergies at the time of testing, and no orofacial anomalies. Subjects repeated oral syllables and the word "hamper" after an examiner. Mean pressures, airflows, and velopharyngeal orifice areas were obtained for each utterance produced by each subject. A discriminate function analysis was performed to determine whether data could be grouped by age, gender, or utterance type. Results indicated significant differences in data for age groups 5 to 8 years, 9 to 13 years, and 14 to 18 years. There were no significant differences between data for male subjects versus female subjects or for different utterance types. Pressures generally decreased, whereas airflows and orifice areas increased with age. Results for 14 to 18 year olds were like those for adults. Using these data, a categorization scheme for velopharyngeal function was proposed for use in clinical testing.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The University of Illinois at Chicago, Chicago, Illinois 60612, USA. bsmith@uic.edu
authors.forename: Bonnie E
authors.initials: BE
authors.lastname: Smith
authors.forename: Yash
authors.initials: Y
authors.lastname: Patil
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Guyette
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Brannan
authors.forename: Mimis
authors.initials: M
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D008297:Male; D010614:Pharynx / Q000033:anatomy & histology; D011312:Pressure; D011446:Prospective Studies; D012016:Reference Values; D012129:Respiratory Function Tests / Q000706:statistics & numerical data*; D025363:Rhinomanometry; D013061:Speech Acoustics; D013068:Speech Production Measurement / Q000295:instrumentation / Q000706:statistics & numerical data*; D014160:Transducers, Pressure; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis*