[An evaluation of the speech therapy methods for patients after pharyngoplasty.].
OBJECTIVE
Speech therapy was carried out for patients with speech disorders after pharyngoplasty, and the comparison of speech articulation before and after treatment, was done to evaluate the new method.


METHODS
82 patients with the varying age from 4 to 31 years were included in the current study. The patients' speeches including syllables, word, phrase and sentence were compared before and after treatment according to Chinese Speech Intelligibility Testing Form. The systematic speech training was carried out according to the compensatory articulation characteristics. The steps were as follows. Firstly, the function of velopharyngeal closure should be strengthened. Secondly, the patients were trained with an average duration of 3.83 months (range from 1.5-12 months) according to the following three sequences: One was from phoneme, syllables, phrase, sentence to short paragraph or dialogue, another was from anterior to posterior according to the speech position, and the other was from easy to difficult according to the articulation method, such as from aspirated syllables to non-aspirated syllables, from plosive, fricative to affricative.


RESULTS
There were 71 patients with compensatory articulation characteristic of velopharyngeal incompetence, the speech articulation of patients with glottis plosive increased from preoperative 46.27% to postoperative 97.16% (P<0.001). The speech articulation of patients with pharynx fricative increased from preoperative 57.19% to postoperative 97.72% (P<0.001). There were 11 patients with compensatory articulation characteristic of velopharyngeal adequacy, and the speech articulation of 11 patients with palatalized and lateral misarticulation increased from preoperative 71.10% to postoperative 98.55% (P<0.001).


CONCLUSIONS
The training of velopharyngeal closure should be emphasized on the patients with compensatory articulation resulting from velopharyngeal incompetence after pharyngoplasty, then the correct speech position and method was established. While to the patients with compensatory articulation without velopharyngeal incompetence after pharyngoplasty, the correct speech position and method could be directly established.
Jiang
Li-ping
LP
Department of Oral and Maxillofacial Surgery, Cleft Lip and Plate Center, Ninth People's Hospital, School of Stomatology Shanghai Second Medical University, Shanghai 200011, China.
Wang
Guo-min
GM
Yang
Yu-sheng
YS
Chen
Yang
Y
Wu
Yi-lai
YL
D000293:Adolescent; D000328:Adult; D001184:Articulation Disorders / Q000175:diagnosis / Q000601:surgery / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D006801:Humans; D010614:Pharynx / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013060:Speech; D013070:Speech Therapy / Q000379:methods*; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis / Q000601:surgery; D055815:Young Adult