運動障害性構音障害例におけるパラタルリフト装着の鼻咽腔閉鎖機能に対する影響-口蓋帆挙筋活動の変化を指標にして-

  • 舘村 卓
    大阪大学大学院歯学研究科高次脳口腔機能学講座顎口腔機能治療学教室
  • 野原 幹司
    大阪大学歯学部附属病院顎口腔機能治療部
  • 藤田 義典
    大阪大学歯学部附属病院顎口腔機能治療部
  • 杉山 千尋
    大阪大学歯学部附属病院顎口腔機能治療部
  • 和田 健
    大阪大学大学院歯学研究科高次脳口腔機能学講座顎口腔機能治療学教室

書誌事項

タイトル別名
  • Change in Levator Veli Palatini Muscle Activity in Association with Placement of a Palatal Lift Prosthesis for Patients with Velopharyngeal Incompetence Due to Stroke
  • ―口蓋帆挙筋活動の変化を指標にして―

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説明

Purpose: This study aimed to clarify 1) whether levator veli palatini muscle activity could be changed in association with placement of a palatal lift prosthesis (PLP) for patients with dysarthria associated with velopharyngeal incompetence caused by stroke, and 2) whether, if so, the activity range for speech in relation to possible maximum levator activity could be normalized consistently for all patients.<BR>Method: Four patients suffering from hypernasality after stroke were examined using electromyography of the levator veli palatini muscle during speech and blowing, in conditions both of placement and removal of a palatal lift prosthesis. Speech tasks were tentime productions of each of /mu/, /u/, /pu/, /su/, and /tsu/. For blowing tasks, each subject was called on to blow at three different intensity levels of low-effort, comfortable, and high-effort.<BR>Results: In the removed condition, EMG activity for blowing increased with oral air pressure in all four subjects. During speech, EMG activity was distributed in a greater activity region relative to maximum activity, which was determined by the greatest levator activity across the experiments for each subject. These findings were consistent across all subjects. When the PLP was in place, the EMG activity range for speech decreased close to 50% of the maximum activity level in all subjects.<BR>Conclusion: The results obtained here suggest that change in the levator EMG in relation to targeted tasks in association with application of a PLP may resemble that observed for normal speakers and wearers of a PLP with repaired cleft palate. This implies that application of a PLP in speakers with dysarthria could normalize not only resonance but also aspect of regulation of velopharyngeal function.

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