Nasality (disorder)
A nasality disorder occurs when an acoustically audible deviation of the physiological nasality of the respective Phonembestandes present.
Various terms in the literature, mainly for historical reasons, for one and the same disease used. So dive next Rhinolalie, Rhinophonie, Rhinophonolalie, Palatophonolalie also Dysglossia palatalis. Is these concepts have in common that they reflect primarily on fault causes, impacts or locations, the expression of the disturbed nasality is, without these may stand fast in their uniqueness. It should therefore be dispensed with these terms and the descriptive term nasality disorder are used wherever possible. We distinguish between forms of open nasality ( hypernasality ) from the closed twang (hypo nasality ). When hypernasality there is an increased involvement of the nasal resonance chambers (typical for cleft palate ) in hypo nasality to reduced participation (typically the common cold ). A mixed twang ( by combining Veluminsuffizienzen and laying of the nasal cavity ) is rather rare.
Physiology
See nasality
Diagnostics
Especially the medicine (especially the Departments of Phoniatrics and Pediatric Audiology, ENT and maxillo -facial surgery ) deals with nasality disorder.
Important is the subjective auditory impression. In addition to the general impression of spontaneous speech special test sets with combinations of nasals and plosives, as well as various vowels, consonants and their compounds. An easily performed semi-quantitative test is the Gutzmann' test '. It is based on the different degree of the velum with the vowels / a / ( larger opening ) and / i / ( complete occlusion ). With the Czermak panel let the nasal airway punches semi-quantitative detection in speech also. With a phonendoscope can be monitored specifically the nasal blows. In addition to the procedure referred to medical practice relies on the Nasometrie as an objective and quantitative method. The case certain nasalance values can, for example, in the ( post-operative ) therapy provide information about the Velumfunktion and the progress of therapy (eg from LKG patients), are useful therapeutically itself by auto- feedback. In some regions of Germany standard values for nasalance have been determined.
To assess the genesis carried an organic study of the institutions involved:
Currently, a more wide range of technical, objective procedures are nonexistent and tested, revealing the opening degree and the flexibility of the velum can give - for example, electromagnetic Artikulografie, high frequency Videokinematografie, Diagnostic Radiology / videofluoroscopy, electromyography, spectrography ( sonogram ), but are mainly for research purposes use.
Causes
Basically, two groups of causes are distinguished:
- Organic causes
Organic causes are impairments of the soft palate ( velum ) by malformations (primarily cleft as Velumspalte, cleft lip and palate ), paralysis, injuries, tumors, but also changes in the nasal cavity itself as septal deviation, turbinate hyperplasia, malformations, tumors.
- Functional causes
For functional reasons, the organic function of the system itself in order, by consciously or unconsciously applied malfunction the twang is triggered. Apart from psychological causes such as counts a posture after an operation in the area to (often after tonsillectomy or adenoidectomy ).
Therapy
In addition to, if possible elimination of the organic damage come through surgery ( closure of gap formation, septoplasty, Muschelkaustik ) or surgical reduction of the distance between the velum and posterior pharyngeal wall ( Velopharyngoplastik ) especially " practicing " therapeutic procedures for carrying on which, by correcting the pathological air power steering an approximation to the physiological nasality is brought about.