Instrumental assessment and treatment of hypernasality, following maxillofacial surgery, using SNORS: a single case study

Main, Alison and Kelly, Stephen W. and Manley, Graham (1999) Instrumental assessment and treatment of hypernasality, following maxillofacial surgery, using SNORS: a single case study. International Journal of Language and Communication Disorders, 34 (2). pp. 223-238. ISSN 1460-6984. (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

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The super nasal oral ratiometry system (SNORS) is a commercially available system which measures both nasal and oral airflow during speech, allowing the very rapid movement of the velum to be measured. SNORS uses a modified oxygen mask, which houses the airflow sensors and microphones, and a standard personal computer. By calculating nasalance (the percentage of airflow that is nasal), an estimation of velopharyngeal closure, which is independent of speech intensity, is achieved. SNORS can be used for objective assessment, where the subject is required to speak a number of words selected to demonstrate velopharyngeal function. SNORS also provides biofeedback, using a simple realtime display of nasal and oral airflow. Velopharyngeal insufficiency (VPI) is the inability to make adequate velopharyngeal closure, and may be the result of either neurological or, as in this case, structural abnormalities. It results in abnormal speech characteristics, such as omissions, substitutions or weak articulation of consonants, and hypernasality. T.W., a 52 year old male, had very hypernasal speech following extensive maxillofacial surgery, for the removal of a tonsillar carcinoma. SNORS was successfully used as both an assessment and a therapy tool in the treatment of this patient. The effectiveness of conventional speech and language therapy vs. SNORS biofeedback therapy was compared. Initially, while there was some movement of the velum, the patient could not achieve velopharyngeal closure. Conventional therapy aimed to strengthen and improve the function of the velum and following this there was some minimal improvement: the patient could now achieve, but not maintain, closure. Reassessment, following a non-treatment period, showed little further change. SNORS biofeedback therapy was then given. This raised the patient's awareness of his velopharyngeal function, thus helping him to maintain closure, thereby reducing hypernasality. SNORS therapy proved significantly more effective than conventional speech and language therapy, in this case. Further intervention is outlined, and the benefits of multiparameter assessment of speech are discussed.

Item Type: Article
Uncontrolled keywords: hypernasality; velopharyngeal insufficiency; SNORS; nasalance
Subjects: P Language and Literature > P Philology. Linguistics
Divisions: Faculties > Humanities > School of English
Depositing User: Tina Thompson
Date Deposited: 07 Apr 2009 17:01
Last Modified: 28 May 2014 08:20
Resource URI: (The current URI for this page, for reference purposes)
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