腭咽功能不全言语障碍的诊断(英文)

WilliamsWilliamN.;ZhangShuangchuan;WhartonPaul;TumerGlennE.;HuaQingquan;TaoZezhang

1:CraniofacialCenterUniversityofFloridaGainesville!Florida

2:DeparmentofPediatries

3:IstAffiliatedHospital

4:HubeiMedicalUniversity!Wuhan

摘要
腭咽功能不全(Velopharyngcal insufficiency,YPI)言语障碍是指腭咽口不能完全关闭引起的一种称为腭裂言语状况.Warred指出腭咽关闭不全仅仅遗留10~20mm2的缺口即可影响正常言语产生.腭咽功能不全的原因可以是腭咽口结构异常(包括腭裂、深鼻咽腔、短软腭等),也可以是神经功能障碍和学习发音方法不当.只有依据口腔检查、言语功能评价、X线影像和鼻内窥镜观察腭咽口所获得的信息进行综合评价,才能正确选择最佳而恰当的矫治方法,包括外科手术、赝体修复和行为治疗,口腔检查评价:要正确识别软、硬腭解剖学结构和运动形式,正常言语时软腭的中1/3与咽后壁接触,腭帆下1/3包括悬雍垂由下向上覆盖并形成一向前倾斜的角度以关闭腭咽口,口腔检查还可识别扁桃体肥大、软腭痿管、软腭上举不对称(发ah时)、软腭粘膜下裂隙等,言语评价:目的是为了决定(1)腭咽功能不全是持续性还是间歇性;(2)在言语障碍中VPI作用所占的比例.评价包括测量口腔和鼻腔共鸣、发口腔辅音时并漏气情况、言语连贯程度和言语可懂度.具体方法有:①纸条振动试验,即令病人发10个双音节单词,包含20个非鼻腔爆破音,检查者持一小纸条置于患者鼻孔下方,观察并评价鼻腔漏气振动纸条的单词数,记录其分数在0/10~10/10之间;②过度鼻音试验,令患者发10个口
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作者
WilliamsWilliamN.;ZhangShuangchuan;WhartonPaul;TumerGlennE.;HuaQingquan;TaoZezhang
参考文献

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