구음장애 환자에서의 연구개인두부운동에 대한 방사선학적 연구 = A Radiological Study on the Velopharyngeal Movement of Dysarthric Patients

다국어 초록 (Multilingual Abstract)

Velopharyngeal incompetency may be the main cause of dysarthria. Velopharyngeal incompetency can be induced by congenital anomalies, such as cleft palate and short soft palate and derformity of soft palte, or complication of adenoidectomy, and neuromuscular disorders affecting the velopharyngeal movement. The present study is aimed to evaluate the velopharyngeal movement in dysarthric patients. The materia consisted of 38 cases of Radiology, Yonsei University College of Medicine from September, 1982 through August, 1983. The radiologic examinations of the soft palate and pharynx were done at neutral and phonation state using Toshiba 500mA imaging intensifier. All cases were subjected to morphometric analysis by measuring the soft palate and pharynx. Results obtained were as follows : 1. In control group. the length of the soft palate was 40.7$\pm$0.7mm in neutral state and increased 11% in vowel sound, 13% in consonant sound. The thickness of the soft palate was 9.4$\pm$0.19mm in neutral state and increased 17% in vowel sound, 16% in consonant sound. The distance between the lateral pharyngeal walls was 36.2$\pm$0.92mm in neutral state and decreased 8% in vowel sound, 11% consonant sound. The gap between the soft palate and posterior pharyngeal walls was not present and the levator eminence was higher than the level of the hard palate in phonation. 2. Among the dysarthric patients, 1) in group of dysarthric patients with morphological abnormality, the thickness of soft palate was minimally changed in relation to the control group, while the distance between the lateral pharyngeal walls was more decreased than the control group. The gap between the soft palate and posterior pharyngeal wall was more than 3mm in 90.9% of these cases, and the levator eminence was at or below the level of hard palate. 2)In group of dysarthric patients with functional abnormality, the contraction of soft palate and pharynx was inefficient in relation to the control group. The gap between the soft palate and posterior pharyngeal wall was more than 3mm in 80% of these cases, and the levator eminence was at or below the level of hard palate. 3) In group of dysarthric patinets without morphological and functional abnormality, the measurement of soft palate and pharynx were similar to the control group. The gap between the soft palate and posterior pharyngeal wall was not present in almost cases, and the levator eminence was at or above the level of hard palate. 3. In summary, the results obtained from the study suggest the treatment modality of dysarthric patients. First, the patients with morphological abnormality of velopharynx must be preceded by surgical correction such as palatoplasty or pharyngoplasty, followed by speech thereapy. Second, the patients with functional abnormality of velopharynx must be preceded by medical management of underlying disorders, followed by speech therapy. Third, dysarthric pateints without morphological and functional abnormality of velopharynx must be preceded by speech therapy.