Evaluation of velopharyngeal function after relocation pharyngoplasty for obstructive sleep apnea.
OBJECTIVE
To assess if relocation pharyngoplasty (RP) causes velopharyngeal dysfunction in patients with obstructive sleep apnea (OSA) by evaluating perioperative nasalance, nasality, voice, and articulation.


METHODS
Prospective, comparative study.


METHODS
Twenty-four OSA patients selected for RP (two women and 22 men; mean age, 35 years) were enrolled for the study of velopharyngeal function in speech. The RP procedure involved removal of supratonsillar adipose tissue, preservation of all palatal muscular structure, splinting the lateral pharyngeal wall, and anterior advancing of the soft palate. Measurements of nasalance (vowel /a/, /i/, consonant /m/, oronasal, oral, and nasal texts), nasality (mirror-fogging test, degree of nasality, Gutzmann test and Bzoch hypernasality test), voice (acoustic analysis), and articulation (velar sound) were taken before RP and 3 months after the procedure and compared.


RESULTS
Comparative analysis of clinical measures showed that no significant differences were found following RP in nasalance (except for the vowel /a/), nasality, articulation, and voice. The only difference with regard to vowel /a/ showed, instead of an increase, a significant decrease of nasalance from 17.3 + or - 10.8 to 11.3 + or - 6.7 (P = .004), which may be attributed to the advancing and lifting of the soft palate in RP, leading to relaxation of the levator veli palatine and uvular muscles, which facilitates their contraction in velopharyngeal closure during particular vowel phonation.


CONCLUSIONS
RP for OSA does not cause velopharyngeal insufficiency in terms of voice, nasality, and articulation in spite of anterior advancement of the soft palate, but does induce a nondetrimental change in nasalance.
Department of Otolaryngology, Sleep Center, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan. hyli38@adm.cgmh.org.tw
Hsueh-Yu
HY
Li
Li-Ang
LA
Lee
Tuan-Jen
TJ
Fang
Wan-Ni
WN
Lin
Wen-Ying
WY
Lin
D000328:Adult; D001184:Articulation Disorders / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010160:Palate, Soft / Q000503:physiopathology / Q000601:surgery*; D010614:Pharynx / Q000503:physiopathology / Q000601:surgery*; D010699:Phonation / Q000502:physiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology*; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery*; D013018:Sound Spectrography; D013061:Speech Acoustics; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology / Q000601:surgery*; D014832:Voice Disorders / Q000175:diagnosis / Q000503:physiopathology