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T Bressmann

Publications and source records attributed to T Bressmann.

7 recordsLinked to original sources
PubMed2002

[Speech outcome after simple and multiple cleft palate operations].

OBJECTIVES: If the primary palatal closure in a patient with cleft lip and palate is unsuccessful, defects such as palatal fistulas and a short velum have to be corrected by secondary operations. It is an informal belief among surgeons that these reoperations can have detrimental effects on the patients' nasal resonance and articulation. It was our aim to critically evaluate the validity of this belief. MATERIAL AND METHODS: One hundred and twenty-four patients with cleft lip and palate were divided into three groups. The 70 patients in group 1 had only undergone a primary palatal closure operation. The 33 patients in group 2 had undergone one or more palatal reoperations. The 21 patients in group 3 had undergone an additional pharyngeal flap operation. Resonance and articulation were evaluated perceptually. Nasalance was assessed with the NasalView system, and the mean speech rate was analyzed with the MODIAS software. RESULTS: There were no significant differences for any of the speech measures between groups 1 and 2. Patients in group 3 had significantly worse results for all speech measures. CONCLUSIONS: The speech outcomes for patients with multiple palatal reoperations were no different from those of patients with single palatal closure operations. The pharyngeal flap operation did not lead to sufficient improvements in the speech of the patients in group 3.

Adolescent↗
PubMed2000

Nasalance distance and ratio: two new measures.

OBJECTIVES: Mean nasalance in speakers with perceptually normal nasal resonance can differ in magnitude considerably. In addition, categorizations of speech based on nasalance scores may not agree with perceptual judgments. To overcome this limitation, we evaluated two new simple measures derived from mean nasalance data: the nasalance distance (range between maximum and minimum nasalance) and the nasalance ratio (minimum nasalance divided by maximum nasalance). SETTING: Department of Oral and Maxillofacial Surgery, University of Technology, Munich, Germany. SUBJECTS: The sample consisted of 133 cleft lip and palate patients with normal nasal resonance or varying degrees of hypernasality. PROCEDURES: Oral and nasal acoustic measurements were made using the NasalView system. Nasalance distance and nasalance ratio were calculated for five non-nasal and three nasal sentences from the modified Heidelberg Rhinophonia Assessment Form. RESULTS: Optimum cutoffs were derived from receiver-operating characteristics. Results for the sentence stimuli ranged from 64.4% to 89.6% sensitivity and from 91.2% to 94.1% specificity. When the analysis was limited to only one nonnasal and one nasal sentence, results ranged from 79.7% to 87.5% sensitivity and from 88.2% to 97.1% specificity. CONCLUSIONS: We conclude that the two new measurements are valuable in routine clinical examinations. Nasalance distance and ratio derived from sentence stimuli are two useful and easily applicable measures that can be used to supplement the nasalance mean value.

Adolescent↗
PubMed1999

[Quantitative diagnosis of hypernasality in cleft lip and palate patients by computerized nasal quality assessment].

In patients with cleft lip and palate (CLP), the assessment of velopharyngeal morphology and function and the quantitative analysis of perceptual consequences of velopharyngeal insufficiency are of major importance regarding the effective planning of velopharyngoplasties for speech improvement. The NasalView, a new instrument for the objective assessment of rhinophonia, is presented. The NasalView measures nasalance, the relative sound pressure level of the nasal signal in speech, expressed as a percentage. In order to evaluate the effectiveness of the computerised measurement of nasalance, 156 patients with surgically treated CLP were examined. The NasalView differentiated with high sensitivity and specificity between patients with normal nasal resonance and patients with varying degrees of hypernasality. To illustrate the importance of the NasalView for making the decision for a velopharyngoplasty, a single case is presented.

Adolescent↗
PubMed1999

[Quality of life research in patients with cleft lip and palate: preliminary results].

While esthetic and functional outcomes of treatment have improved for patients with cleft lip and palate (CLP), a CLP remains a severe problem for patients and relatives. To date, psychological research has dealt with issues such as intelligence, self-consciousness or treatment satisfaction but the long-term impact of a CLP on a psychological construct such as quality of life has yet to be explored. From a pool of 156 patients with CLP, subgroups of varying sizes were examined with a set of standardized questionnaires (KINDL, SF-36, Social Support Survey). In all patients, primary operative treatment had been accomplished. Long-term impact of the CLP on family life was assessed by 112 of the patients' parents by filling in the Impact on Family Scale. A set of questionnaires, especially developed for patients with CLP, was administered as well. For all patients who have been being treated in an interdisciplinary cleft center for their entire life, the results presented indicate that quality of life is good and within a normal range. Social support appears to be within a normal range. Parents report only minor long-term impact of the CLP on family life and family planning. Treatment satisfaction is high in the CLP patients. The questionnaires especially aimed at CLP patients indicate more specific problems mainly concerning social acceptance, where patients think the CLP had a negative impact. The standardized questionnaires employed so far failed to capture these problems. The combination of the two types of questionnaires is a sufficiently sensitive assessment procedure.

Adolescent↗
PubMed1999

[Speech rate of compensatory articulation in patients with cleft lip and palate].

Infolge eines primären Defizits der velopharyngealen Funktion liegen bei vielen Patienten mit Lippen-Kiefer-Gaumenspalten sekundäre kompensatorische Lautbildungen vor. Mit zwei neuen Computerprogrammen werden die Auswirkungen der kompensatorischen Artikulation auf die durchschnittliche Sprechgeschwindigkeit von 146 Patienten mit Lippen-Kiefer-Gaumen-spalten untersucht. Die Patienten wurden dabei nach dem Schweregrad der artikulatorischen Auffälligkeit gruppiert. Bei der schnellen Silbenwiederholung zeigte sich, dass die durchschnittliche Silbenrate pro Sekunde bei Patienten mit deutlich auffälliger Artikulation signifikant reduziert war. Beim Nachsprechen von Sätzen war die zum Nachsprechen benötigte Gesamtzeit bei dieser Patientengruppe signifikant erhöht, und das Zielwort des Satzes wurde signifikant später begonnen. Die Ergebnisse zeigen, dass die mittlere Sprechgeschwindigkeit von Patienten mit Lippen-Kiefer-Gaumenspalten mit kompensatorischer palatolalischer Artikulation niedriger ist.

Adolescent↗
PubMed1998

[Perceptive and instrumental examination of voice quality in patients with lip-jaw-palate clefts].

BACKGROUND: In Anglo-American literature, prevalences as high as 41% are reported for voice disorders in cleft lip and palate (CLP) patients. Because of considerable variability in the reported findings and because no prevalence data are available for the German-speaking area, a screening study was conducted. METHOD: 154 patients with CLP were examined. Voice quality was assessed perceptively according to the rbh-system (roughness, breathiness, hoarseness). Suprasegmentals and nasal resonance were also assessed. Using a new computer programme for the apparative analysis of voice quality, data for pitch, intensity and pertubation (jitter and shimmer) were obtained for 4 sustained vowels. RESULTS: Based on perceptual analysis, we found that the prevalence of severe voice disorders in CLP patients was 6.5% which is lower than reported in most other studies. The incidence of voice disorders in CLP patients is numerically only slightly higher than in the normal population. The acoustic measurements confirm the results of perceptual analysis. Since the prevalence of severe voice disorders was low, none of the pertubation quotients differentiated between modal and disordered voices. A weak correlation was found between jitter and the ratings for hoarseness. CONCLUSIONS: 1. While it is appropriate to assume a higher potential risk for vocal dysfunction in CLP patients the actual prevalence in the patients examined is numerically only slightly higher than in normals. 2. For patients with voice disorders, apparative diagnostics of voice quality is a useful and practical adjunct to perceptual analysis which helps profiling individual patients and helps the professional to make decisions for therapy.

Adolescent↗