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- W1975172645 abstract "Inappropriate emission of air through the nose (nasal escape) and abnormal nasal resonance in speech are usually associated with unrepaired or failed repaired cleft palate, but can occur with a number of congenital and acquired conditions affecting both the hard and soft palate and the pharyngeal wall. Any connection between oral and nasal cavities with an area greater than about 10 sq mm’ will allow perception of resonance of air in the nose and/or air to be heard to escape through the nose as a hissing, bubbling or snorting sound. In general the noticeability of these sounds is proportionate to the size of the communication between the cavities but there are exceptions such as nostril stenosis, septal deviation or hypertrophy of the inferior turbinate which can partially or totally obturate a large oro-nasal fistula as can a well fitting denture. Similarly, the inappropriate nasal resonance resulting from disorders of the velopharyngeal isthmus will be less apparent in the child whose nasopharynx is largely filled with adenoids than in the adult whose adenoids have atrophied. Nasal resonance is normal on the vowels accompanying the English consonants m, n and ng when the velopharyngeal isthmus is not closed. When it does not occur, as the nasopharynx and nasal cavities become occluded by mucus in the common cold or adenoid hypertrophy, the condition is referred to as hyponasal resonance while increased resonance occurring on all other consonant vowel combinations is referred to as hypernasal. A special form of hypernasal resonance with velopharyngeal speech disorder but without nasal air escape is known as cul-de-sac resonance due to the obstruction of the nasal passages. As some consonants are articulated with the tongue in such a position that it obturates a palatal fistula at the moment of production, no air will escape, for example, d in the post alveolar area and g in the mid palatal area. When the condition producing an abnormal communication of oral and nasal cavities predates the acquisition of articulation, abnormal patterns of articulation may develop and may render speech unintelligible and may even result in the child being labelled intellectually subnormal. When normal articulation patterns have been established prior to the occurrence of abnormal communication, these persist and intelligibility will be impaired little, if at all. However, a drop in pitch and loss of volume and length of utterance can produce stress on the speech mechanism with aching in the throat and nodules on the vocal chords.g, ’ Embarrassment can be extreme with patients presenting a shy, withdrawn demeanour, unwilling to speak in an audible voice; some find that a head down posture actually reduces the incompetence. Correction of the underlying condition produces a dramatic change. Parents report improved sociability, school performance and release from special institutions to normal schools in some cases." @default.
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- W1975172645 date "1994-01-01" @default.
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- W1975172645 title "Velopharyngeal (speech) disorder (VP(S)D) without overt cleft palate" @default.
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- W1975172645 doi "https://doi.org/10.1016/0007-1226(94)90002-7" @default.
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