先天性腭咽闭合不全的腭咽闭合状态及语音特点分析  

Velopharyngeal closure pattern and speech characteristics of patients congenital velopharyngeal insufficiency

作　　者：王希 郭春丽[1] 石冰[1] 尹恒[1] Wang Xi;Guo Chunli;Shi Bing;Yin Heng(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Dept.of Cleft Lip and Palate Surgery,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室/国家口腔疾病临床医学研究中心/四川大学华西口腔医院唇腭裂外科,成都610041

出　　处：《华西口腔医学杂志》2020年第6期662-666,共5页West China Journal of Stomatology

基　　金：四川大学华西口腔医院临床新技术项目(LCXJS2017-9)。

摘　　要：目的研究先天性腭咽闭合不全(CVPI)患者的腭咽闭合模式、腭咽口各部分收缩情况及语音特点。方法回顾2009—2017年于四川大学华西口腔医院唇腭裂外科就诊的CVPI患者的病历资料,分析其共鸣状况、辅音构音表现及辅音正确率,采用鼻咽内镜观察患者的腭咽闭合模式以及软腭、咽侧壁和咽后壁的运动情况。结果共纳入47例CVPI患者,均接受了鼻咽内镜检查,29例(61.7%)为环状闭合,16例(34.0%)为冠状闭合,2例(4.3%)为矢状闭合;25例(53.2%)患者软腭动度中度,占比最高;22例(46.8%)患者咽侧壁动度弱,41例(87.2%)患者咽后壁无动度。所有患者均有不同程度的高鼻音表现,其中23例(48.9%)为中度高鼻音,占比最高。47例患者中5例(10.6%)构音正常,42例(89.4%)存在不同程度构音障碍。不同构音方法正确率的高低排序为:鼻辅音>边音>擦音>塞音>塞擦音。不同构音位置正确率的高低排序为:唇音>舌前音>舌后音>舌面音。结论环状闭合是CVPI患者最主要的腭咽闭合模式,辅音省略是最常见的构音障碍。Objective To analyze velopharyngeal closure patterns and speech characteristics of patients with congenital velopharyngeal insufficiency.Methods Patients visiting the Department of Cleft Lip and Palate Surgery,West China Hospital of Stomatology,Sichuan University between 2009 and 2017 were reviewed.Outcomes of subjective speech evaluation,including resonance,consonant articulation,and correction rate,were analyzed.Furthermore,the mobility of soft palate and pharyngeal walls under nasopharyngeal fiberscope were analyzed retrospectively.Results A total of 47 cases were retrieved and subjected to nasopharyngeal fiberscopic examination.Among them,29(61.7%)demonstrated a circular closure pattern,16(34.0%)showed a coronal pattern,and 2(4.3%)had a sagittal pattern.Furthermore,25(53.2%)presented medium soft-palate mobility,22(46.8%)had weak lateral pharyngeal wall mobility,and 41(87.2%)had no posterior pharyngeal wall mobility.Among all of the patients,23(48.9%)presented medium hypernasality,accounting for the highest proportion.Consonant misarticulation occurred in 89.4%of the cases.The articulation manners with the highest correction rate were in the following order:nasal,lateral,fricatives,stops,and affricates.The articulation places with the highest correction rate were in the following order:bilabial,alveolar,velar,and linguadental.Conclusion Circular closure was the most prevalent velopharyngeal closure pattern among patients with congenital velopharyngeal insufficiency,and consonant omission was the most common articulation abnormality.

关 键 词：先天性腭咽闭合不全 腭咽闭合模式 腭裂语音 

分 类 号：R782.2[医药卫生—口腔医学]