title: Immediate and sustained changes in tongue movement with an experimental palatal "fistula": a case study.
abstract: OBJECTIVE
  To determine the immediate and longer-term effect(s) on tongue movement following the placement of an experimental opening through a palatal obturator (replicate of subject's prosthesis) worn by an adult male with an unrepaired cleft of the hard and soft palate.
  
  
  METHODS
  Tongue movements associated with an anterior experimental opening of 20 mm(2) were examined under three conditions: a control condition in which the subject wore the experimental obturator completely occluded, a condition immediately after drilling the experimental openings through the obturator, and a condition after 5 days in which the subject wore the experimental obturator with the experimental opening. An Electromagnetic Articulograph was used for obtaining tongue movements during speech.
  
  
  RESULTS
  The findings partly revealed that the immediate introduction of a perturbation to the speech system (experimental fistula) had a temporary effect on tongue movement. After sustained perturbation (for 5 days), the system normalized (going back toward control condition's behavior). Perceptual data were consistent with kinematic tongue movement direction in most of the cases.
  
  
  CONCLUSIONS
  Although the immediate response can be interpreted as indicative of the subject's attempts to move the tongue toward the opening to compensate for air loss, the findings following a sustained perturbation indicate that with time, other physiological adjustments (such as respiratory adjustments, for example) may help reestablish the requirements of a pressure-regulating system.
authors.affiliation: Phonoaudiology Department, State University of São Paulo-UNESP, Campus Marília, Brazil. vivianemarino@yahoo.com
authors.forename: Viviane C C
authors.initials: VC
authors.lastname: Marino
authors.forename: William N
authors.initials: WN
authors.lastname: Williams
authors.forename: Paul W
authors.initials: PW
authors.lastname: Wharton
authors.forename: Martha F
authors.initials: MF
authors.lastname: Paulk
authors.forename: Jeniffer C R
authors.initials: JC
authors.lastname: Dutka-Souza
authors.forename: Geralyn M
authors.initials: GM
authors.lastname: Schulz
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D000704:Analysis of Variance; D001184:Articulation Disorders / Q000209:etiology / Q000503:physiopathology*; D002972:Cleft Palate / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009068:Movement; D016155:Oral Fistula / Q000150:complications / Q000503:physiopathology*; D010158:Palatal Obturators; D013062:Speech Articulation Tests / Q000295:instrumentation; D014059:Tongue / Q000503:physiopathology*