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PHYSIOANATOMY OF NASOPHARYNGEAL SPACE AND HYPERNASALITY IN CLEFT PALATE
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ÃÖÈ«½Ä ( Choi Hong-Shik ) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ À̺ñÀÎÈÄ°úÇб³½Ç
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½ÉÇö¼· ( Sim Hyun-Sub ) - ÀÌÈ¿©ÀÚ´ëÇб³ Ư¼ö±³À°Çаú
KMID : 0358920040310040721
Abstract
ºñÀΰÆó¼â¶õ ¿¬±¸°³, ÀεÎÃøº® ±×¸®°í ÀεÎÈĺ®°£ÀÇ ¿òÁ÷ÀÓÀÌ ¼·Î Á¶ÈµÇ¾î ±¸°°ú ºñ°À» ³ª´©¾îÁÖ´Â °ý¾à±Ù ±âÀüÀ¸·Î¼ ¿¬ÇÏ, È£Èí, ¹ßÀ½ µîÀÇ »ý¸®Àû±â´É¿¡ Áß¿äÇÑ ¿ªÇÒÀ» ÇÑ´Ù. ÀÌ ±â´É¿¡ ¹®Á¦°¡ »ý±ä °æ¿ì¸¦ ºñÀΰÆó¼âºÎÀüÀ̶óÇÏ¸ç ±× ¿øÀÎÀ¸·Î´Â (1) ¿¬±¸°³ÀÇ ±æÀÌ ¹× ¿òÁ÷ÀÓÀÌ»ó (2) ºñÀεΰÀÇ ÇغÎÇÐÀû °ø°£¹®Á¦ (3) ÀεΠÈĺ®°ú Ãøº®ÀÇ ±â´ÉÀÌ»ó µîÀÌ ÀÖ´Ù.
º» ¿¬±¸´Â ±¸°³¿ ȯÀÚÀÇ Ãø¸éµÎºÎ¹æ»ç¼±°èÃø»çÁøÀ» ÅëÇØ ºñÀεΰÀ» »ý¸®ÇغÎÇÐÀûÀ¸·Î ºÐ¼®ÇÏ¿´À¸¸ç »êÃâµÈ ¸»¼Ò¸®ÀÇ °úºñÀ½Á¤µµ¸¦ Nasometer·Î Æò°¡ÇÏ¿´´Ù. À̷κÎÅÍ ¾òÀº Á¤»ó±º°ú ±¸°³¿È¯ÀÚ±ºÀÇ °á°ú¸¦ °¢°¢ ºñ±³ÇÏ¿´À¸¸ç, ºñÀΰÆó¼âºÎÀü°úÀÇ ¿¬°ü¼ºÀ» ¾Ë¾Æº¸±â À§ÇÏ¿© Anatomic VPI¿Í Nasalance scoreÀÇ °ªÀ» ºñ±³ºÐ¼®ÇÏ¿´´Ù.
¾ò¾îÁø °á°ú´Â ´ÙÀ½°ú °°¾Ò´Ù.
1. Ãø¸éµÎºÎ¹æ»ç¼±°èÃø»çÁø °á°ú, ¿¬±¸°³ ±æÀÌ, ¿¬±¸°³ µÎ²², ºñÀΰ ±íÀÌ, ºñÀΰ ¸éÀû, Adequate ratio¿¡¼ µÎ ±×·ì°£ À¯ÀÇÇÑ Â÷À̸¦ ³ªÅ¸³»¾ú´Ù.
2. Nasometer °á°ú. ¸ðÀ½/¿À/¿Í ±¸°°ø¸íÀ½¹®Àå, ±¸°ÀåÇØÀ½¹®Àå¿¡¼ µÎ ±×·ì °£ À¯ÀÇÇÑ Â÷À̸¦ ³ªÅ¸³»¾ú´Ù.
3. ±¸°³¿È¯ÀÚ±º¿¡¼ ºñÀεΰÀÇ Æó¼âºÎÀü Á¤µµ¸¦ Ç¥ÇöÇØÁÖ´Â Anatomic VPI¿Í Nasalance score´Â Àü¹ÝÀûÀ¸·Î ¿¬°ü¼ºÀÌ ¾ø¾ú´Ù. ´Ù¸¸, ¸ðÀ½/ÀÌ/¿Í ÀϺΠ±¸°ÀÚÀ½À¸·Î ÀÌ·ç¾îÁø ¹®Àå¿¡¼ ´Ù¼ÒÀÇ »ó°ü¼ºÀ» ³ªÅ¸³»¾ú´Ù.
°á·ÐÀûÀ¸·Î, Ãø¸éµÎºÎ¹æ»ç¼±°èÃø»çÁø°ú Nasometer °¢°¢ÀÇ °Ë»ç°á°ú¿¡¼ µÎ ±×·ì°£ À¯ÀÇÇÑ Â÷À̸¦ ã¾Æº¼ ¼ö ÀÖ¾úÀ¸³ª, ±¸°³¿È¯ÀÚ±º³»¿¡¼ ºñÀΰÆó¼âºÎÀüÀ» Ç¥ÇöÇÏ´Â Anatomic VPI¿Í Nasalance score´Â ¸ðÀ½/ÀÌ/¿Í ±¸°ÀÚÀ½À» Æ÷ÇÔÇÑ ¹®ÀåÀ» Á¦¿ÜÇÏ°í´Â Àü¹ÝÀûÀ¸·Î ¿¬°ü¼ºÀÌ ¾ø¾ú´Ù.
Velopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral and nasal cavity. It participates in physiological activities such as swallowing, breathing and speech. It is called a velopharyngeal dysfunction when this mechanism malfunctions. The causes of this dysfunction are defects in (1) length, function, posture of the soft palate, (2) depth and width of the nasopharynx and (3) activity of the posterior and lateral pharyngeal wall.
The purposes of this study are to analyze the nasopharynx of cleft palate patients using cephalometry and to evaluate the degree of hypernasality using nasometry to find its relationship with velopharyngeal dysfunction.
The following results were obtained :
1. In cephalometry, there were significant differences in soft palate length, soft palate thickness, nasopharyngeal depth, nasopharyngeal area, and adequate ratio between two groups.
2. In nasometry, there were significant differences between two groups in vowel /o/ and sentences including oral consonants.
3. In cleft palate patients, though no general correlation was found between Anatomic VPI and nasalance scores, vowel /i/ and sentences including oral consonants were slightly correlated.
In conclusion, cephalometry and nasometer results were significantly different between the two groups. Though in the cleft palate group. Anatomic VPI and nasalance scores, which are indices for velopharyngeal closure, excluding the vowel /i/ and sentences including oral consonants show generally no significance.
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Velopharyngeal Dysfunction;Cephalometry;Nasometer;Hypernasality;Cleft palate
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