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구개봉합술 후 발생한 구비강누공의 폐쇄 후 말소리 결과 : 증례보고
Speech Outcome after Closure of Oronasal Fistula Following Cleft Palate Repair: A report of a case

대한구순구개열학회지 2009년 12권 1호 p.1 ~ 6

서민교, 김다와, 김은주, 윤보근, 김성일, 임대호, 고승오, 문승영, 김현기, 신효근,

소속 상세정보

서민교 ( Seo Min-Gyo ) - 전북대학교 치의학전문대학원 구강안악면외과학교실
김다와 ( Kim Da-Wa ) - 전북대학교 대학원 임상언어병리학과
김은주 ( Kim Eun-Ju ) - 전북대학교 치의학전문대학원 구강안악면외과학교실
윤보근 ( Yoon Bo-Keun ) - 전북대학교 치의학전문대학원 구강안악면외과학교실
김성일 ( Kim Sung-Il ) - 전북대학교 치의학전문대학원 구강안악면외과학교실
임대호 ( Leem Dae-Ho ) - 전북대학교 치의학전문대학원 구강안악면외과학교실
고승오 ( Ko Seung-O ) - 전북대학교 치의학전문대학원 구강안악면외과학교실
문승영 ( Moon Seung-Young ) - 전북대학교 치의학전문대학원 구강안악면외과학교실
김현기 ( Kim Hyun-Gi ) - 전북대학교 대학원 임상언어병리학과
신효근 ( Shin Hyo-Keun ) - 전북대학교 치의학전문대학원 구강안악면외과학교실

KMID : 0952820090120010001

Abstract

Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter, had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in . Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.