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Speech Results Following Modified Pharyngeal Flap Surgery Western Michigan University ScholarWorks at WMU Master's Theses Graduate College 12-1984 Speech Results Following Modified Pharyngeal Flap Surgery Karen S. Zalewski Follow this and additional works at: https://scholarworks.wmich.edu/masters_theses Part of the Speech Pathology and Audiology Commons Recommended Citation Zalewski, Karen S., "Speech Results Following Modified Pharyngeal Flap Surgery" (1984). Master's Theses. 1573. https://scholarworks.wmich.edu/masters_theses/1573 This Masters Thesis-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Master's Theses by an authorized administrator of ScholarWorks at WMU. For more information, please contact [email protected]. SPEECH RESULTS FOLLOWING MODIFIED PHARYNGEAL FLAP SURGERY by KAREN S. ZALEWSKI A Thesis Submitted to The Faculty of The Graduate College in partial fulfillment of the requirements for the Degree of Master of Arts Department of Speech Pathology and Audiology Western Michigan University Kalamazoo, MI December 1984 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. SPEECH RESULTS FOLLOWING MODIFIED PHARYNGEAL FLAP SURGERY Karen S. Zalewski, M.A. Western Michigan University, 1984 It is the purpose of this study to provide a descriptive analysis of 13 patients who have undergone a modified pharyngeal flap surgery completed by one plastic surgeon. Variables associated with the speech of these individuals were based on four measures, including a questionnaire, the Iowa Pressure Articulation Test, the screening portion of the Tempiin-Darley Test of Articulation, and listener ratings of audio-taped post-surgi c* 1 speech samples. Of the eight subject variables studied, two variables were found to be closely associated with speech results. These variables included number of surgeries performed on subjects and number of years in speech therapy. The rating scales were also found to be effective instruments for the measurement of hypernasal resonance and nasal emission. Information gathered in this study would be helpful to others who seek to evaluate the effects on speech of individuals who have undergone various surgical interventions for the improvement of speech articulation and intelligibility. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ACKNOWLEDGEMENTS Many persons were instrumental in the completion of this study, and all deserve to be recognized for their val­ uable contributions. I wo.uld first like to thank my com­ mittee: Chairman Dr. Clyde Willis, for his support and guidance, Dr. Frank Newman, for his helpful suggestions and permission for patient evaluations, Dr. Nickola Nelson, who was instrumental and invaluable in the organization and de­ sign of this study, Mr. Jeffrey Higginbotham, for his as­ sistance in statistical analysis and graphics, and especi­ ally Dr. John Hanley, for his unlimited guidance, motiva­ tion, and encouragement throughout the research period. Sincerest appreciation is extended to Hr. William Dawson, for advising in the design of audio taping proce­ dures, the Department of Speech Pathology and Audiology and the College of Health and Human Services for the use of their faci lities and equipment, and especially The Graduate College, for financial support through The Graduate College Research Fund. Thanks are also extended to Dr. Newman's staff, patients and parents for their cooperation during the collection of data. Finally, the author would like to thank her parents, family and Mr. Alan Ferenc for their unlimited support during this research period. Karen S. Zalewski ii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. INFORMATION TO USERS This reproduction was made from a copy of a document sent to us for microfilming. While the most advanced technology has been used to photograph and reproduce this document, the quality of the reproduction is heavily dependent upon the quality o f the material submitted. The following explanation of techniques is provided to help clarify markings or notations which may appear on this reproduction. 1.The sign or “target” for pages apparently lacking from the document photographed is “Missing Page(s)”. If it was possible to obtain the missing page(s) or section, they are spliced into the film along with adjacent pages. This may have necessitated cutting through an image and duplicating adjacent pages to assure complete continuity. 2. When an image on the film is obliterated with a round black mark, it is an indication of either blurred copy because of movement during exposure, duplicate copy, or copyrighted materials that should not have been filmed. For blurred pages, a good image o f the page can be found in the adjacent frame. If copyrighted materials were deleted, a target note will appear listing the pages in the adjacent frame. 3. When a map, drawing or chart, etc., is part of the material being photographed, a definite method of “sectioning” the material has been followed. It is customary to begin filming at the upper left hand comer of a large sheet and to continue from left to right in equal sections with small overlaps. If necessary, sectioning is continued again—beginning below the first row and continuing on until complete. 4. For illustrations that cannot be satisfactorily reproduced by xerographic means, photographic prints can be purchased at additional cost and inserted into your xerographic copy. These prints are available upon request from the Dissertations Customer Services Department. 5. Some pages in any document may have indistinct print. In all cases the best available copy has been filmed. University Microfilms International 300 N. Z eeb Road Ann Arbor, Ml 48106 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1 3 2 4 8 3 8 ZALEWSKI, KAREN SUE SPEECH RESULTS FOLLOWING MODIFIED PHARYNGEAL FLAP SURGERY WESTERN MICHIGAN UNIVERSITY M.A. 1984 University Microfilms International300 N. Zeeb Road, Ann Arbor. MI 48106 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. PLEASE NOTE: In all cases this material has been filmed in the best possible way from the available copy. Problems encountered with this document have been identified here with a check mark V 1. Glossy photographs or p ages. 2. Colored illustrations, paper or print______ 3. Photographs with dark background 4. Illustrations are poor cop______ y 5. Pages with black marks, not original copy. 6. Print shows through as there is text on both sid es of page. 7. Indistinct, broken or small print on several p ages l / 8. Print exceeds margin requirements______ 9. Tightly bound copy with print lost in spine_____ 10. Computer printout pages with indistinct print. 11. Page(s)_________ _ lacking when material received, and not available from school or author. 12. Page(s) seem to be missing in numbering only as text follows. 13. Two pages numbered ______ . Text follows. 14. Curling and wrinkled pages ____ 15. Other ________________ University Microfilms International Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS ACKNOWLEDGEMENTS ...... ii LIST OF TABLES ........ v LIST OF FIGURES ........ vi CHAPTER I. INTRODUCTION ............ 1 Experimental Questions ......... .3 II. REVIEW OF THE LITERATURE ..... 4 Patterns of Velopharyngeal Closure ............. 4 Velopharyngeal Closure Evaluation ....... 9 Management of Velopharyngeal Insufficiency ..... 13 Related Information ............... 23 III. METHOD ........... 26 Subject Selection ....................... 26 Procedures ....... 28 Reliability ....... 31 Listener Judgment ............ 33 IV. RESULTS ............ 38 Speech Articulation Test Results ........... 38 Relationship of Subject Variables to Articulation Scores and Ratings ........... 39 Relationship of Selected Subjects to Unavailable Subjects ............... 71 V. DISCUSSION AND CONCLUSIONS .......... 75 Score Distribution and Related Variables ..... 75 iii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Implications ..... 87 Conclusions ......... 91 APPENDICES A. Letter of Inquiry ........ 96 B. Questionnaire and Explanatory Letter ........... 98 C. Consent Letter ....... 103 D. TDST and IPAT Items ........ 105 E. Rating Instructions, Rating Scales, Response Form • • 108 F. Selected Subject Characteristics, Means and Standard Deviations .......... 116 G. Comparisons between Selected Subjects (Group A) and Subjects Not Available (Group B) for Analysis of Selected Variables ........ 118 BIBLIOGRAPHY.. .......... ........ 120 iv Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. L IS T OF TABLES 1. Misaiticulations Associated with Cleft Palate Speakers ............ 30 2. Chi Square and Phi Coefficient Values for High and Low Speech Articulation Scores Compared to Selected Variables ... 44 3. Means and Standard Deviations of Judges' Mean Ratings of of Speech Quality Grouped by High
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