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1.
Artículo en Ruso | MEDLINE | ID: mdl-32621468

RESUMEN

OBJECTIVE: To develop the classification and methodology for assessment of speech disorders in neurodegenerative diseases, and to identify the characteristics of speech disorders for various forms. MATERIALS AND METHODS: The study included 1016 patients with neurodegenerative diseases. Screening assessment identified 42.1% patients with speech disorders exceeding isolated dysarthria. Patients were assessed using the speech disorder test battery developed by the authors. Cluster, multifactor and contingency analyses were performed. RESULTS: Nine subtypes of speech disorders were identified in neurodegenerative diseases that we denominated as dysphasia. Based on contingency analysis, the principal and the additional dysphasia variants were identified for each form of neurodegenerative pathology, which may contribute to better understanding of various phenotypes. Based on the general scheme of speech origination, the level of disorders typical for a given dysphasia subtype was identified. CONCLUSION: The proposed classification enables identification of the subtypes of speech disorders for individual forms of neurodegenerative diseases. Introducing dysphasia concept to clinical practice will improve differential diagnosis and understanding of phenotypical heterogeneity of each nosological form as well as will facilitate therapy optimization.


Asunto(s)
Afasia , Enfermedades Neurodegenerativas/complicaciones , Trastornos del Habla/etiología , Afasia/etiología , Diagnóstico Diferencial , Humanos
2.
Codas ; 32(4): e20190152, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32401996

RESUMEN

Purpose This study investigated the influence of the cleft type on the appearance of hypernasality after surgical maxillary advancement (MA). Methods Nasality was determined by measurement of nasalance (acoustic correlate of nasality) by nasometry. The study involved analysis of the nasalance scores of 17 individuals with isolated cleft palate (CP), 118 with unilateral cleft lip and palate (UCLP) and 69 with bilateral cleft lip and palate (BCLP), of both sexes, aged 18 to 28 years, after MA. Only individuals with normal nasalance scores indicating balanced resonance before MA were included in this study. Nasometry was performed 3 days before and 15 months after MA, on average. The proportion of patients who presented nasalance scores indicating hypernasality after surgery was calculated by the ANOVA test, and comparison among the different cleft types was evaluated by the chi-square test (p < 0.05). Results No significant difference was found in the proportions of individuals with hypernasality among the cleft types. Conclusion Nasometry showed that the appearance of hypernasality after MA in individuals with cleft palate with or without cleft lip occurred in similar proportions, regardless of the cleft type.


Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Procedimientos Quirúrgicos Ortognáticos/efectos adversos , Trastornos del Habla/etiología , Habla/fisiología , Insuficiencia Velofaríngea/etiología , Adolescente , Adulto , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Femenino , Humanos , Masculino , Maxilar/cirugía , Osteotomía Le Fort/efectos adversos , Estudios Retrospectivos , Trastornos del Habla/fisiopatología , Medición de la Producción del Habla , Insuficiencia Velofaríngea/fisiopatología , Adulto Joven
3.
J Appl Oral Sci ; 28: e20190399, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32348443

RESUMEN

Objectives To evaluate the acoustic properties of the /s/ sound in individuals with different occlusion types and to investigate relationships between these properties and cephalometric measurements. Methodology Sixty patients were divided into three groups based on malocclusion. Group 1 included 20 patients (mean age: 14.85±2.01 years) with Class I skeletal and dental relationships. Group 2 included 20 patients (mean age: 13.49±1.78 years) with Class II skeletal and dental relationships. Group 3 included 20 patients (mean age: 12.46±2.62 years) with Class III skeletal and dental relationships. Cephalometric tracings were obtained from cephalometric radiographs. All included patients were native speakers of Turkish. The /s/ sound was selected for center of gravity analysis. Correlations between cephalometric values and acoustic parameters were also investigated. Results The center of gravity of the /s/ sound had the lowest value in Group 2 (p<0.05). For the /s/ sound in Group 3, moderate positive correlations were found between center of gravity and Sella-Nasion to Gonion-Gnathion angle (p<0.05, r=0.444) Lower incisor to Nasion-B point (p<0.023, r=0.505), and Lower incisor to Nasion-B point angle (p<0.034; r=0.476). No correlation was found in other cephalometric measurements. Conclusions The /s/ sound was affected by malocclusion due to the changing place of articulation. Therefore, referral to an orthodontist for malocclusion treatment especially patients with class III in the early period is suggested for producing acoustically ideal sound.


Asunto(s)
Cefalometría , Maloclusión/fisiopatología , Acústica del Lenguaje , Trastornos del Habla/fisiopatología , Adolescente , Niño , Femenino , Humanos , Masculino , Maloclusión/complicaciones , Maloclusión/diagnóstico por imagen , Mandíbula/anatomía & histología , Mandíbula/fisiopatología , Maxilar/anatomía & histología , Maxilar/fisiopatología , Estudios Prospectivos , Radiografía , Valores de Referencia , Trastornos del Habla/diagnóstico por imagen , Trastornos del Habla/etiología , Estadísticas no Paramétricas , Lengua/anatomía & histología , Lengua/fisiopatología , Turquia
4.
Plast Reconstr Surg ; 145(4): 803e-813e, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32221229

RESUMEN

BACKGROUND: Macroglossia, a cardinal feature of the (epi)genetic disorder Beckwith-Wiedemann syndrome, is associated with obstructive sleep apnea, speech and/or feeding difficulties, and dental or jaw malalignment. These sequelae may be treated and/or prevented with tongue reduction surgery; the authors sought to determine whether certain Beckwith-Wiedemann syndrome patients may benefit from early surgical intervention before age 12 months. METHODS: The authors conducted a retrospective review of patients with Beckwith-Wiedemann syndrome who underwent tongue reduction from 2014 to 2019. The authors assessed primary outcomes of change in obstructive sleep apnea by polysomnography, respiratory support required, and feeding route before and after tongue reduction, and reviewed postoperative complications and the need for repeated tongue reduction. RESULTS: Of the 36 patients included, the median age at tongue reduction was 9.5 months (interquartile range, 3.8 to 22.8 months). For those with severe obstructive sleep apnea, there was a significant reduction in the obstructive apnea hypopnea index from 30.9 ± 21.8 per hour to 10.0 ± 18.3 per hour (p =0.019) and improvement in nadir oxyhemoglobin saturation from 72 ± 10 percent to 83 ± 6 percent (p =0.008). Although there was no significant change in overall supplemental feeding tube or respiratory support, there were specific patients who experienced clinically meaningful improvement. Of note, these positive outcomes applied equally to those who underwent surgery at a younger age (<12 months). To date, only one patient required a repeated tongue reduction. CONCLUSION: Based on improved polysomnographic findings and rarity of surgical complications or repeated surgery, the authors' data support the safety and efficacy of this early intervention when clinical indications are present and an experienced multidisciplinary team is available for consultation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Asunto(s)
Síndrome de Beckwith-Wiedemann/cirugía , Glosectomía/métodos , Macroglosia/congénito , Complicaciones Posoperatorias/epidemiología , Apnea Obstructiva del Sueño/cirugía , Síndrome de Beckwith-Wiedemann/complicaciones , Síndrome de Beckwith-Wiedemann/genética , Preescolar , Estudios de Factibilidad , Métodos de Alimentación/estadística & datos numéricos , Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Trastornos de Alimentación y de la Ingestión de Alimentos/prevención & control , Femenino , Estudios de Seguimiento , Glosectomía/efectos adversos , Humanos , Lactante , Macroglosia/complicaciones , Macroglosia/genética , Macroglosia/cirugía , Masculino , Polisomnografía/estadística & datos numéricos , Complicaciones Posoperatorias/etiología , Sistema de Registros/estadística & datos numéricos , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/etiología , Trastornos del Habla/etiología , Trastornos del Habla/prevención & control , Tiempo de Tratamiento , Lengua/cirugía , Resultado del Tratamiento
5.
J Craniofac Surg ; 31(1): 226-229, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31725501

RESUMEN

INTRODUCTION: The aim of this study was to evaluate pre-operative nutritional status, associated syndromes and abnormalities, and post-operative outcomes of patients with Pierre Robin Sequence (PRS) versus those with non-syndromic isolated cleft palate (CIP). METHODS: Between January 1995 and December 2013, patients with a cleft palate Veau I-II according to the Veau classification with and without PRS who underwent primary repair were retrospectively analyzed. The nutrition status, age at the time of palatoplasty, additional anomalies, gestational complications, and post-operative speech abnormalities and outcomes were evaluated. RESULTS: A total of 59 patients with PRS (PRS group) and 132 patients without PRS (non-PRS group) were included in the study. Of all patients, 92 were males and 99 were females with a mean age of 14 ±â€Š4.18 (range, 6 to 26) years. The rate of gestational complications, enteral nutrition, complete cleft, additional anomalies, and velopharyngeal insufficiency was significantly higher in the PRS group (P < 0.05). However, the incidence of fistulas and age at the time of palatoplasty did not significantly differ between the groups. CONCLUSION: Based on our study results, enteral nutrition, respiratory problems, pregnancy complications, velopharyngeal insufficiency, and additional anomalies, but not post-operative palatal fistulas, are more frequently seen in patients with PRS. Although pre-operative care and treatment and rehabilitation in patients with PRS are more complicated than those with the CIP, our experience demonstrates that meticulous repair and follow-up can minimize complications, such as fistulas.


Asunto(s)
Fisura del Paladar/cirugía , Síndrome de Pierre Robin/cirugía , Adolescente , Adulto , Niño , Femenino , Fístula , Humanos , Incidencia , Masculino , Complicaciones Posoperatorias/epidemiología , Periodo Posoperatorio , Estudios Retrospectivos , Trastornos del Habla/etiología , Resultado del Tratamiento , Insuficiencia Velofaríngea , Adulto Joven
6.
Int J Pediatr Otorhinolaryngol ; 128: 109692, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31568953

RESUMEN

INTRODUCTION: Lipofilling of the upper lip as secondary treatment in patients with a cleft lip (and palate) (CL ±â€¯P) has been proposed to improve projection and volume especially in profile view. The purpose of the present study was to document differences in functional (i.e. logopaedic) and self-reported aesthetic outcomes by comparing pre- and postoperative results after lipofilling of the upper lip in patients with CL ±â€¯P. METHODS: Eight Dutch-speaking youngsters and young adults (three women, five men) with CL ±â€¯P were included. The median age was 19 years (range: 14-24 years). Logopaedic outcomes (i.e. assessment of orofacial myofunctional behavior, articulation and lip strength) and self-reported aesthetic outcome (i.e. patients' satisfaction using the Cleft Evaluation Profile) were determined. RESULTS: Neither for lip strength and orofacial myofunctional behavior nor for articulation statistically significant differences were found when comparing measurements before and after lipofilling. Regarding patients' satisfaction, a statistically significant increased self-evaluation of appearance in profile was found after lipofilling. CONCLUSION: Regarding functionality, the present study did not find any differences when comparing outcomes before and after lipofilling. Nevertheless, patients were more satisfied with appearance in profile after performance of this technique. As this is a small sample study, further research and long-term follow-up studies are necessary.


Asunto(s)
Labio Leporino/fisiopatología , Labio Leporino/terapia , Rellenos Dérmicos/uso terapéutico , Labio/fisiopatología , Satisfacción del Paciente , Adolescente , Labio Leporino/complicaciones , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Estética , Músculos Faciales/fisiopatología , Femenino , Humanos , Masculino , Fuerza Muscular , Proyectos Piloto , Habla , Pruebas de Articulación del Habla , Trastornos del Habla/etiología , Adulto Joven
7.
Tidsskr Nor Laegeforen ; 139(18)2019 Dec 10.
Artículo en Noruego | MEDLINE | ID: mdl-31823567

RESUMEN

BACKGROUND: Stroke has several causes and the diagnostic investigation can be challenging. Neurosyphilis occurs when Treponema pallidum infects the central nervous system, and is a rare cause of stroke. CASE PRESENTATION: A man in in his late forties with diabetes mellitus and overweight presented with headache, speech impairment and right-sided stroke symptoms. He also had cognitive impairment and psychiatric symptoms. He underwent intravenous thrombolysis, and standardised stroke investigation was without clear findings. Cerebral MRI demonstrated non-specific subtle changes in the primary motor cortex in the left frontal lobe. However, lumbar puncture revealed elevated white blood cell count, and syphilis tests were positive. INTERPRETATION: Diagnosis of syphilis is often difficult and requires specific suspicion. Due to increasing incidence of the disease and its therapeutic consequences, alertness around the condition is important. Neurosyphilis should be suspected in young patients with stroke symptoms in the absence of risk factors and/or with cryptogenic strokes, especially in the presence of risk factors for syphilis infection and in patients from endemic areas.


Asunto(s)
Neurosífilis , Trastornos del Habla , Humanos , Masculino , Persona de Mediana Edad , Neurosífilis/complicaciones , Neurosífilis/diagnóstico , Paresia/etiología , Trastornos del Habla/etiología , Serodiagnóstico de la Sífilis , Treponema pallidum
8.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(9. Vyp. 2): 32-36, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31825387

RESUMEN

Speech disorders are widely spread in patients with Parkinson's disease, and these symptoms are only getting worse as the disease progresses. Nevertheless, only a few percent of the population have an access to an adequate and qualified care. This review describes the pathophysiology of parkinsonian speech disorders, methods of diagnostics and monitoring and treatment modalities, which include pharmacotherapy, speech therapy and surgical approaches. The authors believe that treatment of parkinsonism-related speech disorder is an integral part of a multidisciplinary patient care.


Asunto(s)
Enfermedad de Parkinson , Trastornos del Habla , Disartria , Humanos , Enfermedad de Parkinson/complicaciones , Trastornos del Habla/etiología , Trastornos del Habla/terapia , Logoterapia
9.
Codas ; 31(6): e20180296, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31800882

RESUMEN

PURPOSE: To investigate the reliability in auditory-perceptual assessment of hypernasality of the Borg centiMax scale and the influence of the speech material on the reliability of two scales. METHODS: Four experienced speech-language pathologists rated hypernasality of 80 audio recordings of patients with repaired cleft palate (40 single-word string and 40 sentences) using the 5-point ordinal scale and the Borg centiMax scale. Intra and inter-rater reliability were calculated for both scales and for both types of speech samples. The comparison between the agreement coefficients of the two speech samples was calculated using the Z test and between the scales was calculated by Spearman correlation coefficient, considering as significant p<0.05. RESULTS: A very high and statistically significant correlation was found between the Borg centiMax scale and the ordinal scale for both speech samples. Intra- and inter-rater reliability was higher for Borg scale as compared to ordinal scale. Good to excellent intra-rater reliability was found for Borg scale for both speech samples. Poor to excellent intra-rater reliability was found for ordinal scale for both stimuli. Higher inter-rater reliability was demonstrated for Borg scale than ordinal scale for both speech samples. There was a significant difference between the single words string and sentences for intra- and inter-rater reliability using Borg scale, and for inter-rater reliability using ordinal scale. CONCLUSION: The Borg centiMax scale showed better intra and inter-rater reliability. Additionally, the speech material comprising of single words string showed better reliability in most of the comparisons for both scales.


Asunto(s)
Trastornos del Habla/diagnóstico , Medición de la Producción del Habla/instrumentación , Calidad de la Voz , Fisura del Paladar/fisiopatología , Humanos , Reproducibilidad de los Resultados , Trastornos del Habla/clasificación , Trastornos del Habla/etiología , Insuficiencia Velofaríngea/fisiopatología , Trastornos de la Voz/fisiopatología
10.
BMC Neurol ; 19(1): 309, 2019 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-31787082

RESUMEN

BACKGROUND: The mechanisms underlying the online modulation of motor speech in Parkinson's disease (PD) have not been determined. Moreover, medical and rehabilitation interventions for PD-associated motor speech disorder (MSD) have a poor long-term prognosis. METHODS: To compare risk factors in PD patients with MSD to those without MSD (non-MSD) and determine predictive independent risk factors correlated with the MSD phenotype, we enrolled 314 PD patients, including 250 with and 64 without MSD. We compared demographic, characteristic data, as well as PD-associated evaluations between the MSD group and non-MSD group. RESULTS: Univariate analysis showed that demographic characteristics, including occupation, educational level, monthly income and speaking background; clinical characteristics, including lesions in the frontal and temporal lobes, and concurrent dysphagia; and PD-associated evaluations, including the activity of daily living (ADL) score, non-motor symptoms scale (NMSS) domain 4 score (perceptual problem), and NMSS domain 5 score (attention/memory) were all significantly different between the MSD and non-MSD group (all P < 0.05). Multivariate logistic regression analysis showed that educational level, frontal lesions, and NMSS domain 5 score (attention/memory) were independent risk factors for PD-associated MSD (all P < 0.005). CONCLUSIONS: We determined an association between MSD phenotype and cognitive impairment, reflected by low-level education and related clinical profiles. Moreover, attention and memory dysfunction may play key roles in the progression of MSD in PD patients. Further studies are required to detail the mechanism underlying abnormal speech motor modulation in PD patients. Early cognitive intervention may enhance rehabilitation management and motor speech function in patients with PD-associated MSD.


Asunto(s)
Disfunción Cognitiva/etiología , Memoria/fisiología , Enfermedad de Parkinson/fisiopatología , Trastornos del Habla/etiología , Adulto , Anciano , Anciano de 80 o más Años , Atención/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad
11.
Codas ; 31(5): e20190004, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31664371

RESUMEN

PURPOSE: To review the Speech-Language Pathology literature studies from the epidemiology and causality perspective. RESEARCH STRATEGIES: A national and international literature survey was carried out with searches from PubMed, SciELO and gray literature bases, conducted according to the instructions of the Cochrane Collaboration and published until January 9th, 2019. The review guiding question asks if Speech-Language Pathology uses methods in their evidence to infer causality. SELECTION CRITERIA: All studies that presented a causal epidemiological approach in speech therapy were included, as well as excluded those that did not present an appropriate methodological approach for cause and effect analysis. DATA ANALYSIS: Two authors of this study independently reviewed all citations. A priori determined form was used to extract the following data: author, year of publication, country of origin, theoretical conception, application or not of the study and central discussion addressed in the article. RESULTS: From the search performed 3842 articles were found. However, none of them investigated their outcomes from the causality point of view, not allowing cause and effect inference. CONCLUSION: There is a shortage of studies that evidence causality in Speech-Language Pathology, which may alter the effectiveness and reliable handling of diagnosis and speech-language therapy, since it is still based on association and not on cause and effect based on studies designed to that.


Asunto(s)
Trastornos del Habla/epidemiología , Trastornos del Habla/etiología , Patología del Habla y Lenguaje , Causalidad , Métodos Epidemiológicos , Humanos , Logoterapia
12.
BMC Neurol ; 19(1): 241, 2019 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-31629403

RESUMEN

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a fatal degenerative disease of a rapid course. In 25% of ALS sufferers, speech disorders occur as prodromal symptoms of the disease. Impaired communication affects physical health and has a negative impact on mental and emotional condition. In this study, we assessed which domains of speech are particularly affected in ALS. Subsequently, we estimated possible correlations between the ALS patients' subjective perception of their speech quality and an objective assessment of the speech organs carried out by an expert. METHODS: The study group consisted of 63 patients with sporadic ALS. The patients were examined for articulatory functions by means of Voice Handicap Index (VHI) and the Frenchay Dysarthria Assessment (FDA). RESULTS: On the basis of the VHI scores, the entire cohort was divided into 2 groups: group I (40 subjects) with mild speech impairment, and group II (23 subjects) displaying moderate and profound speech deficits. In an early phase of ALS, changes were typically reported in the tongue, lips and soft palate. The FDA and VHI-based measurements revealed a high, positive correlation between the objective and subjective evaluation of articulation quality. CONCLUSIONS: Deterioration of the articulatory organs resulted in the reduction of social, physical and emotional functioning. The highly positive correlation between the VHI and FDA scales seems to indicate that the VHI questionnaire may be a reliable, self-contained tool for monitoring the course and progression of speech disorders in ALS. TRIAL REGISTRATION: NCT02193893 .


Asunto(s)
Esclerosis Amiotrófica Lateral/complicaciones , Trastornos del Habla/diagnóstico , Trastornos del Habla/etiología , Patología del Habla y Lenguaje/métodos , Adulto , Anciano , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Habla/fisiología
14.
J Craniofac Surg ; 30(8): 2441-2444, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31261316

RESUMEN

BACKGROUND: To assess speech results following the treatment of mild to moderate velopharyngeal insufficiency (VPI) post cleft palate surgery with autologous fat grafting to the velopharynx. METHODS: A retrospective study was conducted on 9 consecutive patients who underwent velopharyngeal fat grafting for the treatment of VPI at the Red Cross War Memorial Children's hospital from 2010 to 2014. All the patients previously had primary palatoplasty performed and subsequently developed VPI. Patients were assessed pre- and postoperatively by an experienced speech and language therapist looking at perceptual speech and by 2 senior cleft surgeons interpreting lateral view videofluoroscopies. RESULTS: Eleven fat grafting procedures were performed on 9 patients and an average of 5.64 mL (range 1-7 mL) of autologous fat was transferred to the velopharynx. The average age at the time of operation was 6.5 years (range 3-14 years) with a follow-up period of 18 months (range 7-34 months). Most of the patients (7 out of 9) showed improved speech after fat grafting. One of the 7 patients had multiple procedures. The 2 who did not show speech improvement only had a single procedure. There were no complications related to the fat grafting procedure. CONCLUSION: This small study suggests that fat grafting either as a single procedure or as multiple procedures is an effective, safe, minimally invasive surgical alternative, and/or adjunct for the treatment of mild to moderate VPI in patients following cleft palate surgery and to the knowledge, is the first reported study from Africa.


Asunto(s)
Tejido Adiposo/trasplante , Insuficiencia Velofaríngea/cirugía , Adolescente , Autoinjertos/cirugía , Niño , Preescolar , Fisura del Paladar/cirugía , Femenino , Humanos , Masculino , Procedimientos Quirúrgicos Orales/efectos adversos , Periodo Posoperatorio , Procedimientos Quirúrgicos Reconstructivos/métodos , Estudios Retrospectivos , Habla , Trastornos del Habla/etiología , Resultado del Tratamiento , Insuficiencia Velofaríngea/complicaciones
15.
Int J Lang Commun Disord ; 54(6): 902-913, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31338954

RESUMEN

BACKGROUND: Acquired apraxia of speech (AOS) involves speech-production deficits on both the segmental and suprasegmental levels. Recent research has identified a non-linear interaction between the metrical structure of bisyllabic words and word-production accuracy in German speakers with AOS, with trochaic words (strong-weak stress) being resistant to errors compared with iambic words (weak-strong). AIMS: To replicate previous findings in English speakers with AOS, to measure the test-retest reliability of the effect, and to examine the potential impact of different methods of word scoring. METHODS & PROCEDURES: Speech samples were collected from 27 speakers with AOS and aphasia. Participants were at least 12 months post-stroke or penetrating brain injury, and represented a large range of AOS and aphasia severities. Productions were elicited via verbal model. Sampling was conducted on three separate occasions: the initial data-collection session and then repeated samplings at 1- and 4-week intervals. Bisyllabic words with a CVCVC segmental structure were selected. The list was divided into sublists representing differing lexical stress patterns: A list of 42 trochees, and one of 37 iambs. All speech samples were phonetically transcribed and then aligned with canonical transcriptions via an edit distance algorithm that followed transcription alignment principles. Phonetic-level errors (distortions) were penalized less severely than phonemic-level errors. Per cent consonants correct and whole-word accuracy were also examined. Trochee and iamb lists were analysed separately. OUTCOMES & RESULTS: Paired samples t-tests indicated that the modified edit distance was significantly lower for the trochee lists than for the iamb lists. There was a lack of a significant effect of time on the absolute difference between modified edit distance for both lists. Intraclass coefficients suggested the list and procedures used are appropriate as an outcome measure for group research. CONCLUSIONS & IMPLICATIONS: The results suggest that in English, as in German, the trochaic structure is more resistant to segmental errors in persons with AOS and aphasia, providing replication of the findings of Aichert et al. in 2016. Further, this effect is stable over repeated sampling occasions. Implications for clinical management of AOS include possible ways to scaffold item difficulty and potentially improve stimulus generalization.


Asunto(s)
Apraxias/psicología , Trastornos del Habla/psicología , Habla/fisiología , Adulto , Apraxias/etiología , Apraxias/fisiopatología , Femenino , Traumatismos Penetrantes de la Cabeza/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Variaciones Dependientes del Observador , Fonética , Reproducibilidad de los Resultados , Acústica del Lenguaje , Trastornos del Habla/etiología , Trastornos del Habla/fisiopatología , Medición de la Producción del Habla/métodos , Accidente Cerebrovascular/complicaciones
16.
Int J Lang Commun Disord ; 54(6): 875-893, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31322824

RESUMEN

BACKGROUND: There is a growing body of evidence that speech and language therapy (SLT) intervention is effective in improving communication ability for individuals with non-progressive acquired apraxia of speech (AOS). However, there is no universally agreed diagnostic standard for AOS, and diverging opinions on its diagnostic features. This has led to claims that diverse diagnostic criteria may be used to select participants for AOS research studies. These claims raise concerns for evidence-based practice in AOS but have yet to be systematically investigated. AIMS: To determine the presence, nature and extent of diversity in the diagnostic criteria for non-progressive AOS used in both published studies and clinical practice internationally. METHODS & PROCEDURES: The study used a scoping review methodology that followed the 2005 framework of Arksey and O'Malley and included a consultation exercise in the form of an online survey of international SLTs. The scoping review included 157 studies involving participants with acquired AOS, published between 1997 and 2017. There were 264 respondents to the online survey of SLTs, with a completion rate of 72%. Respondents came from 15 countries and had varying levels of clinical experience. MAIN CONTRIBUTION: This study found that no common set of diagnostic criteria for AOS was used universally across research and practice. Although the diagnostic criteria used to select participants with AOS were reported explicitly in most studies, they varied from study to study. Some studies used directly conflicting criteria. Use of specific diagnostic criteria in studies was influenced by year of publication but not by location. There was a trend towards increasing consistency in diagnostic criteria in recent years. Compared with the research, the survey revealed relatively greater consistency among SLTs on the speech features considered indicative of AOS, although the SLTs who responded to the survey showed variation in how diagnostic criteria were combined into sets. Use of specific diagnostic criteria was not associated with SLTs' location or experience. There were differences between the diagnostic criteria for AOS used most commonly in research studies and those selected most commonly by SLTs in the survey. These findings have implications for the generalizability of AOS research to clinical practice, as well as implications for effective research synthesis. CONCLUSIONS & IMPLICATIONS: The claim that research and practice in the field of AOS is characterized by the use of diverse diagnostic criteria is supported by this scoping review. The findings support the need to develop a universal consensus standard for AOS diagnosis to ensure consistency across research and clinical practice.


Asunto(s)
Apraxias/diagnóstico , Trastornos del Habla/diagnóstico , Apraxias/complicaciones , Diagnóstico Diferencial , Humanos , Pruebas del Lenguaje , Trastornos del Habla/etiología , Terminología como Asunto
17.
Eur Arch Otorhinolaryngol ; 276(9): 2577-2584, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31240457

RESUMEN

PURPOSE: Surgical complications after total laryngopharyngectomy (TLP) are common, reconstruction is challenging, and patients often lose their ability to swallow and speak. To evaluate these aspects, we analysed outcome after TLP. METHODS: We reviewed all patients who underwent TLP and subsequent circumferential pharyngeal reconstruction through 2004-2017 at the Helsinki University Hospital. RESULTS: For the 26 eligible patients, TLP was the primary treatment for 11 and salvage surgery for 15, followed by reconstruction with free flaps in 22 patients and pedicled flaps in 4. An early (≤ 30 days) pharyngocutaneous fistula developed in seven patients (27%; median time 13 days; range 6-26), and a late (> 30 days) fistula in five patients (19%; median time 370 days; range 46-785). In addition, ten patients (39%) developed an oesophageal stricture. Four patients (15%) resumed full oral feeding. A speech prosthesis was inserted for 15 patients (58%) and most of them could produce intelligible speech. We found acceptable survival figures for patients undergoing TLP both as a primary treatment and as salvage procedure: the overall survival at 1 year was 82% and 67%, and at 5 years 33% and 27%, respectively. Disease-specific survival at 1 year was 90% and 70%, and that at 5 years was 45% and 43%, respectively. CONCLUSIONS: Despite fair survival, TLP carries a high risk for postoperative complications with limited functional outcome, thus necessitating cautious patient selection and surgical experience.


Asunto(s)
Trastornos de Deglución , Laringectomía , Faringectomía , Complicaciones Posoperatorias , Procedimientos Quirúrgicos Reconstructivos/métodos , Trastornos del Habla , Adulto , Anciano , Trastornos de Deglución/etiología , Trastornos de Deglución/cirugía , Femenino , Finlandia/epidemiología , Humanos , Laringectomía/efectos adversos , Laringectomía/métodos , Laringectomía/mortalidad , Masculino , Persona de Mediana Edad , Evaluación de Procesos y Resultados en Atención de Salud , Faringectomía/efectos adversos , Faringectomía/métodos , Faringectomía/mortalidad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Recuperación de la Función , Estudios Retrospectivos , Trastornos del Habla/etiología , Trastornos del Habla/cirugía , Análisis de Supervivencia
19.
Eur Ann Otorhinolaryngol Head Neck Dis ; 136(5): 355-359, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31178430

RESUMEN

BACKGROUND: Perceptual evaluation is a means of assessing speech disorder severity in clinical practice. Although limited in reliability and reproducibility, its ease of application makes it very widely used. Choice of assessment criteria and type of speech sample are key points. OBJECTIVE: To compare a panel's perceptual evaluations on two tasks with different criteria. MATERIAL AND METHOD: The corpus comprised 87 samples from patients treated for oral cavity or oropharynx cancer, assessed by 6 experts on two criteria (impairment of intelligibility and of speech signal) and two kinds of speech sample (semi-spontaneous versus reading speech) RESULTS: Although strong correlations were found between tasks (r>0.8), the speech signal criterion gave a score distribution providing a better metric. Severity was greater in oral cavity (mean, 5.44±2.47) than oropharyngeal cancer (6.46±2.24). Semi-spontaneous speech tended to show less severity score ceiling effect than reading speech (mean, 6.06/10 for picture description and 6.51/10 for reading). CONCLUSION: Speech signal impairment in semi-spontaneous speech seems to be the best clinical measure to assess speech disorder following treatment of oral cavity or oropharynx cancer.


Asunto(s)
Neoplasias de la Boca/complicaciones , Neoplasias Orofaríngeas/complicaciones , Inteligibilidad del Habla , Medición de la Producción del Habla , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Habla/etiología , Escala Visual Analógica
20.
Neurol Sci ; 40(11): 2391-2397, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31222543

RESUMEN

BACKGROUND: Foreign accent syndrome (FAS) is arare syndrome associated with altered speech rhythm and prosody, which listeners perceive as foreign; cerebrovascular accidents, tumors and multiple sclerosis are reported as possible causes of FAS. The pathophysiology of FAS is not yet understood. CASE PRESENTATION: A 68-year-old Italian man was admitted to the EmergencyDepartment for non-fluent aphasia and dysarthria. Computed tomography (CT) scan did not show abnormalities; the patient was treated with systemic thrombolysis. A repeated brain CT and magnetic resonance imaging (MRI) confirmed an infarct in the left primary motor cortex and mild extension to cortico-subcortical frontal regions. In the following days he gradually improved, speaking Italian fluently with a typical German accent. In conclusion, FAS is a rare motor speech disorder, often related to cerebrovascular accidents involving critical regions in the dominant hemisphere. In addition, the present case adds further evidence to the role of the left primary motor cortex in modulation of prosody. In rare cases FAS can be the only sign of stroke or can appear after recovery from post-stroke aphasia.


Asunto(s)
Infarto Cerebral/complicaciones , Corteza Motora , Trastornos del Habla , Anciano , Infarto Cerebral/diagnóstico por imagen , Humanos , Masculino , Corteza Motora/diagnóstico por imagen , Corteza Motora/patología , Corteza Motora/fisiopatología , Trastornos del Habla/etiología , Trastornos del Habla/patología , Trastornos del Habla/fisiopatología
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