J Korean Radiol Soc.  1984 Mar;20(1):13-23. 10.3348/jkrs.1984.20.1.13.

A radiological study on the velopharyngeal movement of dysarthric patients

• Kim MJ
• Oh KK
• Park CY

• KMID: 2463059
• DOI: http://doi.org/10.3348/jkrs.1984.20.1.13

Abstract

Velopharyngeal incompetency may be the main cause of dysarthria. Velopharyngeal incompetency can be induced bycongenital anomalies, such as cleft palate and short soft palate and deformity of soft plate, or complication ofadenoidectomy, and neuromuscular disorders affecting the velopharyngeal movement. The present study is aimed toevaluate the velopharyngeal movement in dysarthric patients. The material consisted of 38 cases of dysarthricpatients and 30 cases of non-dysarthric control persons examined at the Departement of Radiology, YonseiUniversity College of Medicine from September, 1982 through August, 1983. The radiologic examinations of the softpalate and pharynx were done at neutral and phonation state using Toshiba 500 mA Imaging Intensifier. All caseswere subjected to morhphometric analysis by measuring the soft palate and pharyns. Results obtained were asfollows; 1. In control group, the length of the soft palate was 40.7±0.71mm in neutral state and increased 11% invowel sound, 13% in consonant sound. The thickness of the soft palate was 9.4±0.19mm in neutral state andincreased 17% in vowel sound, 16% in consonant sound. The distance between the lateral pharyngeal walls was36.2±0.92mm in neutral state and decreased 8% invowel sound, 11% consonant sound. The gap between the soft palateand posterior pharyngeal walls was not present and the levator eminence was higher than the level of the hardpalate in phonation. 2. Among the dysarthric patients, 1) In group of dysarthric patients with morphologicalabnormality, the thickness of soft palate was minimally changed in relation to the control group, while thedistance between the lateral phryngeal walls was more decreased than the control group. The gap between the softpalate and posterior phryngeal wall was more than 3mm in 90.9% of these cases, and the levator eminence was at orbelow the level of hard palate. 2) In group of dysarthric patients with functional abnormality, the contraction ofsoft palate and pharynx was inefficient in relation to the control group. The gap between the soft palate andposterior pharyngeal wall was more than 3mm in 805 of these cases, and the levator eminence was at or below thelevel of hard palate. 3) In group of dysarthric patients without morphological and functional abnormality, themeasurement of soft palate and pharynx were similar to the control group. The gap between the soft palate andposterior pharyngeal wall was not present in almost cases, and the levator eminence was at or above the level ofhard palate. 3. In summary, the results obtained from the study suggest the treatement modality of dysarthricpatients. First, the patients wtih morphological abnormality of velopharynx must be preceded by surgicalcorrection such as palatoplasty or pharyngoplasty, followed by speech thereapy. Second, the patients withfunctional abnormality of velopharynx must be preceded by medical management of underlying disorders, followed byspeech therapy. Third, dysarthric patients without morphological and functional abnormality of velopharynx must bepreceded by the speech therapy.

MeSH Terms

Cleft Palate
Congenital Abnormalities
Dysarthria
Humans
Palate
Palate, Hard
Palate, Soft
Pharynx
Phonation
Speech Therapy