腭咽功能不全(Velopharyngcal insufficiency,YPI)言语障碍是指腭咽口不能完全关闭引起的一种称为腭裂言语状况.Warred指出腭咽关闭不全仅仅遗留10～20mm~2的缺口即可影响正常言语产生.腭咽功能不全的原因可以是腭咽口结构异常(包括腭裂、深鼻咽腔、短软腭等),也可以是神经功能障碍和学习发音方法不当.只有依据口腔检查、言语功能评价、X线影像和鼻内窥镜观察腭咽口所获得的信息进行综合评价,才能正确选择最佳而恰当的矫治方法,包括外科手术、赝体修复和行为治疗,口腔检查评价:要正确识别软、硬腭解剖学结构和运动形式,正常言语时软腭的中1/3与咽后壁接触,腭帆下1/3包括悬雍垂由下向上覆盖并形成一向前倾斜的角度以关闭腭咽口,口腔检查还可识别扁桃体肥大、软腭痿管、软腭上举不对称(发ah时)、软腭粘膜下裂隙等,言语评价:目的是为了决定(1)腭咽功能不全是持续性还是间歇性;(2)在言语障碍中VPI作用所占的比例.评价包括测量口腔和鼻腔共鸣、发口腔辅音时并漏气情况、言语连贯程度和言语可懂度.具体方法有:①纸条振动试验,即令病人发10个双音节单词,包含20个非鼻腔爆破音,检查者持一小纸条置于患者鼻孔下方,观察并评价鼻腔漏气振动纸条的单词数,记录其分数在0/10～10/10之间;②过度鼻音试验,令患者发10个口 Velopharyngcal insufficiency (YPI) speech disorder refers to a condition called palatal palate caused by the fact that the mouth of the palatopharyngeal pharynx can not close completely.Warred points out that only a 10-20 mm ~ 2 gap left in the velopharyngeal insufficiency can affect normal speech Velopharyngeal dysfunction may be caused by abnormal palatal pharyngeal structures (including cleft palate, deep nasopharynx, short soft palate, etc.), can also be neurological dysfunction and learning pronunciation improper method only based on oral examination, speech function evaluation, X-ray images and nasal endoscopy to observe the information obtained from the palatopharyngeal mouth comprehensive evaluation, in order to correctly select the best and appropriate correction methods, including surgery, prosthesis repair and behavioral therapy, oral examination evaluation: to correctly identify the soft , The anatomical structure of the palate and the movement form, in normal speech, 1/3 of the soft palate is in contact with the posterior pharyngeal wall, the lower 1/3 of the palatal sag, including the uvula, is covered upwards and forms a forwardly inclined angle to close the palatopharyngeal orifice , Oral examination can also identify tonsils hypertrophy, soft palate tube, asymmetric soft palate (hair ah), soft palate submucosal fissure, speech evaluation: the purpose is to decide (1) velopharyngeal function (2) The proportion of VPI’s effect on speech impairment, including the measurement of oral and nasal resonance, the presence of air leaks, oral coherence and speech intelligibility Specific methods There are: ① paper strip vibration test, that is, the patient made 10 two-syllable words, including 20 non-nasal blasting sound, the examiner holding a small note placed under the patient’s nostrils to observe and evaluate the number of nasal air leak vibration paper words , Recorded its score between 0/10 ~ 10/10; ② excessive nasal test, so that patients made 10 mouth