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Biomedical subjects

K E Morr

Publications and source records attributed to K E Morr.

9 recordsLinked to original sources
PubMed1989

Effects of velar resistance on speech aerodynamics.

The level of intelligibility attained by speakers with cleft palate reflects not only the ability to achieve adequate velopharyngeal closure but other complex variables as well. When closure is inadequate, performance is influenced by compensatory responses of the tongue, vocal folds, respiratory muscles and nasal valve. The purpose of the present study was to determine how a loss of velar resistance associated with velopharyngeal inadequacy affects speech pressures and airflow. The pressure-flow technique (Warren, 1979) was used to assess mean airflow rate, mean intraoral and nasal pressures and velopharyngeal orifice areas in 211 subjects diagnosed as having cleft palate or velopharyngeal inadequacy. The data revealed that resistance fell as velopharyngeal orifice area increased. Intraoral pressures also fell as resistance dropped while nasal pressures and airflow rate increased. These findings suggest that individuals with velar inadequacy and associated low velar resistance compensate by increasing airflow rate in an attempt to maintain adequate pressures for consonant sound production.

Adolescent↗
PubMed1989

Respiratory response to a decrease in velopharyngeal resistance.

Individuals with congenital velopharyngeal impairment generally maintain adequate levels of intraoral pressures during consonant production by increasing respiratory effort. The purpose of the present study was to determine if normal individuals respond to a decrease in velopharyngeal resistance in a similar way. The velar mechanism was perturbed by having subjects voluntarily lower the soft palate during a series of words involving plosive consonants. The pressure-flow technique was used to measure oral pressures, calculate velopharyngeal orifice resistance, and estimate velopharyngeal orifice area. Inductive plethysmography was used to measure breathing volumes associated with the words. The data indicate that, in most instances, intraoral pressure remained at appropriate levels (greater than 3.0 cm H2O) after velar lowering. Speech breathing volume did not change during inspiration, but increased during speech expiration when the velopharyngeal port was open. The difference was statistically significant (p less than 0.01). Duration of the utterance did not change across conditions. A mechanical model was then used to determine how intraoral pressure would be affected by simulating the same conditions in a passive system. The modeling data revealed that pressure would drop threefold. It was concluded that increased respiratory volumes tend to stabilize intraoral pressure when vocal tract resistance is experimentally reduced.

Humans↗
PubMed1989

The speech regulating system: temporal and aerodynamic responses to velopharyngeal inadequacy.

Temporal and respiratory responses to a loss of velar resistance were measured in 107 subjects demonstrating varying degrees of velopharyngeal inadequacy. The subject data were compared to data generated by a mechanical model representing a passive system. The pressure-flow technique was used to estimate velopharyngeal orifice size and measure respiratory and temporal characteristics of aerodynamic events associated with the production of the nasal-plosive blend /mp/ in the word "hamper". Subjects were categorized as having adequate closure (less than 0.05 cm2), adequate/borderline closure (0.05-0.09 cm2), borderline/inadequate closure (0.10-0.19 cm2) and inadequate closure (greater than or equal to 0.20 cm2). The data revealed that intraoral pressure fell 10-fold in the model as velopharyngeal orifice area changed from adequate closure to inadequate. The subject data demonstrated only a 1.4-fold drop in pressure. Airflow data indicated that there was a 10-fold increase in respiratory volume in the subject data corresponding to the change from adequacy to inadequacy. When respiratory and temporal responses were assessed together, the findings revealed that airflow and temporal changes minimized the fall of pressure as velar resistance declined across groups.

Adolescent↗
PubMed1989

Screening of velopharyngeal inadequacy by differential pressure measurements.

Warren (1979) described an approach for screening velopharyngeal inadequacy using a device (PERCI) that measures orifice differential pressure (P). The PERCI score is based on the relationship between velopharyngeal orifice (VPO) area and velopharyngeal orifice differential pressure. The purpose of this study was to test the original assumptions, which were based on modeling experiments and a small sample size. The sample in this study included 515 subjects who demonstrated various degrees of velopharyngeal inadequacy. The pressure-flow technique was used to estimate velopharyngeal orifice size and to measure orifice differential pressure. The data demonstrate that differential pressures greater than 3.0 cm H2O generally predict adequacy of closure, whereas differential pressures less than 3.0 cm H2O usually indicate inadequacy. These findings support the use of orifice differential pressure as a simple screening of velopharyngeal function.

Humans↗
PubMed1988

The relationship between nasal airway size and nasal-oral breathing.

Most clinicians agree that impaired nasal breathing results in obligatory mouth breathing. Some believe that mouth breathing influences dentofacial growth; others disagree. The term mouth breathing is confusing because total mouth breathing rarely occurs. A combination of nasal and oral breathing is more usual. The purpose of the present study involving 116 adult subjects was to (1) assess the relationship between nasal impairment and nasal-oral breathing, (2) determine the switching range from nasal to nasal-oral breathing, and (3) quantify the term mouth breathing. The pressure-flow technique was used to estimate nasal airway size; inductive plethysmography was used to assess nasal-oral breathing in normal and impaired breathers. Analysis of the date showed a Pearson rank correlation of 0.545 (P less than 0.001) between nasal area and nasal-oral respiration. Ninety-seven percent of subjects with a nasal size less than 0.4 cm2 were mouth breathers to some extent. About 12% of subjects with an adequate airway were assumed to be habitual mouth breathers. The findings indicate that the switching range from nasal to nasal-oral breathing is very narrow (0.4-0.45 cm2). These results also confirm our contention that in adults an airway less than 0.4 cm2 is impaired.

Adult↗
PubMed1988

Intraoral pressure, nasal pressure and airflow rate in cleft palate speech.

We have suggested that compensatory behaviors associated with cleft palate may be strategies developed for the purpose of satisfying the requirements of a speech regulating system. The purpose of the present study was to test this hypothesis in subjects demonstrating various degrees of velopharyngeal inadequancy. The pressure-flow technique was used to assess aerodynamic responses to a loss of velar resistance in 74 subjects compared to a control group of 137 subjects with adequate velopharyngeal closure. The results of this study demonstrate that as degree of inadequacy increased, airflow rate also increased. Although intraoral pressure fell as inadequacy increased, many subjects were able to maintain pressures above 3.0 cm H2O by increasing airflow rate. Nasal pressure increased in proportion to the decrease in intraoral pressure while combined nasal plus oral pressure remained constant across groups. These findings suggest that a loss of resistance at the velar port is compensated by an increase in resistance at the nasal port. Airflow rate appears to be adjusted to total upper airway resistance. These findings support our contention that the speech system is constrained to meet aerodynamic requirements.

Adolescent↗
PubMed1988

Intraoral pressure and its relationship to velopharyngeal inadequacy.

Intraoral pressure measurements were made during multiple productions of the word "hamper" by each of 267 patients who manifested differing degrees of velopharyngeal inadequacy. The results indicate that intraoral pressure diminishes as the extent of velopharyngeal impairment increases. However, pressure remained above 3 cm H2O in the majority of subjects, even when the impairment was such that intraoral and intranasal pressures were essentially equal. Comparison of these results with model simulations suggests that speakers make adjustments to velopharyngeal impairment that tend to maintain pressures at levels thought to be necessary for obstruent consonant production. Variations in pressure as a function of gender and age parallel those observed in normal children and adults.

Adolescent↗
PubMed1988

Screening of velopharyngeal closure based on nasal airflow rate measurements.

Although sophisticated techniques for estimating velopharyngeal port area during speech are available, clinicians continue to seek approaches for screening patients with suspected velar inadequacy. The aim of the present study is to determine the sensitivity and specificity of predicting velopharyngeal dysfunction based on nasal airflow measurements. The pressure-flow technique was used to measure velopharyngeal orifice area and nasal airflow rate in 211 subjects with cleft palate or velar dysfunction, or both. The data demonstrate that nasal airflow rates above 125 cc/sec are almost always associated with velar dysfunction. Sensitivity and specificity of this index were high (0.85 and 0.96, respectively). A correct diagnosis was made in 93% of the cases. As expected, errors in judgment occurred most frequently in subjects with borderline velopharyngeal inadequacy.

Adolescent↗