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Evaluation of velopharyngeal function after relocation pharyngoplasty for obstructive sleep apnea
Author(s) -
Li HsuehYu,
Lee LiAng,
Fang TuanJen,
Lin WanNi,
Lin WenYing
Publication year - 2010
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20850
Subject(s) - nasality , soft palate , obstructive sleep apnea , velopharyngeal insufficiency , phonation , medicine , vowel , audiology , pharyngeal flap , nasalization , orthodontics , surgery , anesthesia , philosophy , linguistics
Objectives/Hypothesis: To assess if relocation pharyngoplasty (RP) causes velopharyngeal dysfunction in patients with obstructive sleep apnea (OSA) by evaluating perioperative nasalance, nasality, voice, and articulation. Study Design: 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 ± 10.8 to 11.3 ± 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. Laryngoscope, 2010