title: Assessment of nasalance and nasality in patients with a repaired cleft palate.
abstract: In patients with a repaired cleft palate, nasality is typically diagnosed by speech language pathologists. In addition, there are various instruments to objectively diagnose nasalance. To explore the potential of nasalance measurements after cleft palate repair by NasalView®, we correlated perceptual nasality and instrumentally measured nasalance of eight speech items and determined the relationship between sensitivity and specificity of the nasalance measures by receiver-operating characteristics (ROC) analyses and AUC (area under the curve) computation for each single test item and specific item groups. We recruited patients with a primarily repaired cleft palate receiving speech therapy during follow-up. During a single day visit, perceptive and instrumental assessments were obtained in 36 patients and analyzed. The individual perceptual nasality was assigned to one of four categories; the corresponding instrumental nasalance measures for the eight specific speech items were expressed on a metric scale (1-100). With reference to the perceptual diagnoses, we observed 3 nasal and one oral test item with high sensitivity. However, the specificity of the nasality indicating measures was rather low. The four best speech items with the highest sensitivity provided scores ranging from 96.43 to 100%, while the averaged sensitivity of all eight items was below 90%. We conclude that perceptive evaluation of nasality remains state of the art. For clinical follow-up, instrumental nasalance assessment can objectively document subtle changes by analysis of four speech items only. Further studies are warranted to determine the applicability of instrumental nasalance measures in the clinical routine, using discriminative items only.
authors.affiliation: Department of Cranio-, Maxillofacial and Oral Surgery, Medical University, Waehringer Guertel 18-20, 1090, Vienna, Austria. klaus.sinko@meduniwien.ac.at.
authors.forename: Klaus
authors.initials: K
authors.lastname: Sinko
authors.affiliation: Department of Cranio-, Maxillofacial and Oral Surgery, Medical University, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Maike
authors.initials: M
authors.lastname: Gruber
authors.affiliation: Faculty of Psychology, Institute of Clinical Psychology, University of Vienna, Vienna, Austria.
authors.forename: Reinhold
authors.initials: R
authors.lastname: Jagsch
authors.affiliation: Division of Phonatrics-Logopedics, Department of Otorhinolaryngology, Medical University, Vienna, Austria.
authors.forename: Imme
authors.initials: I
authors.lastname: Roesner
authors.affiliation: Department of Cranio-, Maxillofacial and Oral Surgery, Medical University, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Arnulf
authors.initials: A
authors.lastname: Baumann
authors.affiliation: Department of Cranio-, Maxillofacial and Oral Surgery, Medical University, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Arno
authors.initials: A
authors.lastname: Wutzl
authors.affiliation: Division of Phonatrics-Logopedics, Department of Otorhinolaryngology, Medical University, Vienna, Austria.
authors.forename: Doris-Maria
authors.initials: DM
authors.lastname: Denk-Linnert
mesh_terms: D001317:Austria; D002648:Child; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D012372:ROC Curve; D025363:Rhinomanometry / Q000379:methods*; D012680:Sensitivity and Specificity; D013064:Speech Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D013068:Speech Production Measurement / Q000379:methods
keywords: Cleft palate; Instrumental diagnosis; Nasalance; Nasality; Sensitivity; Specificity