Evaluation On Short-term Acoustic Effects Of VPI Patients After Palatoplasty By Posterior Pharyngeal Flap Combined With Furlow's Operation Over 8 Years Old

Objective The article aimed to evaluate short-term acoustic effects of velopharyngeal incompetence(VPI) patients after palatoplasty aged over 8 years old after prforming posterior pharyngeal flap combined with furlow's operation on the base of studying the speech acoustic features of the VPI patients after palatoplasty,which can provide an objective theoretical and clinic support for treatment of aged VPI patients after palatoplasty.Methods Chapter one:4 vowels,5 consonants and 3 sentences of 20 normal children and 56 VPI patients after palatoplasty was analysised by Multi-speech kay 3700,then Formant(F),Band(B),Pitch and energy of vowels,strike and fills of consonants,Voice Onset Time(VOT) of[ti]and transition sound sign of[ba],[ma]were compared by SPSS 13.0;Chapter two:30 VPI patients after palatoplasty over 8 yeas old of the Department of Oral and Maxillofacial surgery,the Affilitated Hospital of Qingdao University Medical College were included.15 were repaired by Posterior Pharyngeal flap(PF) combined with furlow's operation(Furlow),another 15 patients Palatopharyngeal Muscle flap(PMF) operation only.Rate of velopharyngeal incompetence(RVPI),F₁,F₂ and the F₁'s energy of [i],the spike and fills of[zi],[ci],[si],[ji],[qi],[xi]and Speech intelligibility were compared between anterior and posterior the operation,contrasted with 20 normal children.Results:Experiment one:â‘ there is no significant difference at formants value of [a],[e],[u]and F₁ of[i]among two groups,F₂ and F₃ of[i]is lower in VPI group than normal group;pitch of all of vowels is of no obvious difference in two groups;but all vowels' energy of VPI group is higher than normal group;B₂ and B₃ of[i]is broader in VPI group but B₁ of two groups is close to each other;F_n and A_n of[a]and A₁ of[i] increase in VPI group compare to normal group.â‘¡there are a higher occurrence rate of strike and fills of[zi],[ci],[si],[ji],[qi],[xi]in VPI group than the other one;VOT of[ti] in the first sentence of VPI group is notably lower than normal group;significant change lies in the transition sound sign of[ba]in the last sentence from normal group to VPI group,concretely speaking from ascending to flat.Experiment two:â‘ RVPI of two postoperational groups is lower than their preoperational group individually,and there is no difference in RVPI of PF + Furlow postoperational group and normal group,both of which is lower than the RVPI of PMF postoperational group.â‘¡F₂ and F₃ of[i]increase after both operations,In PF + Furlow group after the operation F₂ is still lower than normal group,but F₃ is the same as the normal group;besides A₁ of PF + Furlow postoperational group is lower than the preoperational group but still higher than normal group.â‘¢There are a higher occurrence rate of strike and fills of[zi],[ci],[si],[ji],[qi],[xi]after the both operation individually,but which of both postoperational groups don't reach the level of normal group.â‘£there is no significant difference in speech intelligibility between PMF preoperational and postoperational groups;however patients' speech intelligibility improve after PF +Furlow operation,but still not good as normal group.Conclusion 1.VPI patients have their special sonogram characteristics and computerized speech analysis techonology can be used to evaluate patients' velopharyngeal conditions.2.Posterior pharyngeal flap combined with furlow's operation can markedly improve Velopharyngeal Competence(VPC) of VPI patients after palatoplasty aged over 8 years old and can be the routine operation for them.