Bakgrund Nasometer är ett datorbaserat instrument som procentuellt mäter andel ljudenergi som vid tal kommer ut via näsan. Nasometern är det främst använda instrumentet vid instrumentell nasalitetsbedömning. I användningen av Nasometer behövs normalvärden från personer med typisk resonansutveckling. Normalvärden för svenska språket finns för flera åldersgrupper, men inte för tonåringar. Syfte Ta fram normalvärden för Nasometer hos svensktalande 13- respektive 18-åringar, studera värdenas spridning samt analysera könsskillnader inom respektive åldersgrupp. Metod  Deltagarna bestod av två grupper; 39 deltagare i åldern 12 - 13 år och 48 deltagare i åldern 18-19 år. Alla deltagarna hade svenska som modersmål samt typisk tal- och språkutveckling. Talmaterialet bestod av ord och meningar med endast orala fonem samt nasala meningar innehållande hög andel nasala fonem. Normalvärden för Nasometer samlades sedan in genom inspelning.   Resultat  Medelvärdena gällande 13-åringar var för orala ord 13,6 % (SD 8,7), orala meningar 11,4 % (SD 6,2) och nasala meningar 60,2 % (SD 12,0). 18-åringars medelvärden var för orala meningar 14,0 % (SD 5,5) och nasala meningar 57,5 % (SD 6,2). Det fanns signifikanta könsskillnader endast för 18-åringar, dock uppvisade flickor/kvinnor deskriptivt något högre medelvärde inom båda grupperna. Slutsatser  Medelvärdena visade stor spridning inom grupperna, speciellt för 13-åringar. Medelvärdena i båda åldersgrupperna i föreliggande studie ligger dock inom spannet för typisk nasalitet, vilket visar att normalvariationen av medelvärde är stor. / Background  The Nasometer is a data-based instrument that measures the amount of acoustic energy from the nose during speech and is the most common instrument for nasalance assessments. To use the Nasometer clinically, normative scores are needed from people with typical resonance development. There are normative scores in Swedish for several age groups, except for teenagers. Aim Collect normative nasalance scores with the Nasometer among two Swedish age groups, study the scores spread and analyze gender differences within the groups. Method  Two groups of participants; 39 participants 12-13 years and 48 participants 18-19 years. All participants used Swedish as their native language and had typical speech- and language development. The speech material consisted of oral word and sentences containing only oral phonemes and nasal sentences containing a high amount of nasal phonemes. Normative scores for the Nasometer were then collected by recording. Results  Means for the younger group were for oral words 13,6 % (SD 8,7), oral sentences 11,4 % (SD 6,2)  and nasal sentences 60,2 % (SD 12,0). Means for the older group were for oral sentences 14,0 % (SD 5,5) and nasal sentences 57,5 % (SD 6,2). Only in the older group there was a significant gender difference but females showed higher descriptive scores in both groups. Conclusions  Means showed great spread within both groups. The means are though within the range for typical nasality. This implicates great variation of means among normal speakers.

The need for a standard approach for the diagnosis of speech disorders, in particular resonance disorders associated with cleft lip and/or palate, has been recognised. A reliable and valid measure of nasality is important, because it not only affects clinical decision making but is also essential for the evaluation of treatment outcomes. In order to allow cross-linguistic comparisons of the assessment of resonance, language specific stimuli developed according to a common set of guidelines have been recommended. The aim of this thesis was to contribute to the development of an assessment protocol for use in Malay speaking individuals with clefts of the lip and/or palate, specifically focusing on the detection of nasality. A series of four studies were completed which systematically developed and then validated a set of stimuli in the Malay language using both perceptual and instrumental measures. / In the first study, three stimuli were developed for the assessment of nasality based on both the proportion of nasal phonemes in typical conversation samples in Malay and guidelines from the current international literature. The phonetic content of the stimuli were comparable to similar passages used in English and comprised of an Oral Passage, a Nasal Passage and a Set of Sentences. / In the second study, the stimuli constructed were tested in a large number of typically developing (non-cleft) Malay speaking children using both instrumental and perceptual methods of assessment. The results of this study provide the first set of normative data of nasalance scores for the three newly developed stimuli. The mean nasalance score for the Oral Passage was 13.86% (SD = 5.11, 95% CI = 13.04–14.68), 60.28% (SD = 6.99, 95% CI = 59.15–61.41) for the Nasal Passage, and 27.72% (SD = 4.74, 95% CI = 26.96–28.49) for the Set of Sentences. These scores were significantly different from each other suggesting that they can be used to detect the different types of resonance disorder in speech (e.g. hypernasality and/or hyponasality). / In the third study, the stimuli were validated in a sample of Malay speaking children with cleft of the lip and/or palate and compared with a control population. Nasality was measured using perceptual evaluation and nasometry. The results suggested that the Oral Passage and Set of Sentences developed in Malay were valid measures for detecting hypernasality for both perceptual evaluation of nasality, and for nasometry. Due to the small number of participants that were hyponasal, the validity of the Nasal Passage could not be determined. / For nasometry to be clinically relevant threshold values that indicate abnormal nasality are required. The threshold values for each of the stimuli were first ascertained after obtaining typical nasality levels from a group of healthy Malay speaking children and then tested in a sample of cleft and non-cleft Malay speaking children. In contrast to the nasalance cutoffs obtained from typical Malay speaking children, the cutoffs obtained from the cleft children yielded better outcomes for detecting resonance disorders. The cutoffs were: ≥ 22% for the Oral Passage (sensitivity = 0.91, specificity = 0.93, overall efficiency = 0.92), ≥ 30% for the Set of Sentences (sensitivity = 0.96, specificity = 0.85, overall efficiency = 0.88) and ≤ 39 on the Nasal Passage (sensitivity = 1.00, specificity = 0.99, overall efficiency = 0.99). / Finally, the fourth study explored the application of recently developed techniques for assessing nasality using spectral voice analysis and compared these results with nasometry using a sub-sample of Malay speaking children from the third study. The participants were children with cleft lip and/or palate with perceived hypernasality and a group of healthy controls perceived to have normal resonance. The potential of assessing nasality using vowels, which ideally can be an easier option to administer clinically and have minimal impact on language and literacy skills, were investigated. / The findings showed that only the one-third-octave analysis method could be successfully used to detect hypernasality in the cleft population compared to the VLHR method. Using the one-third-octave analysis, the spectral characteristics of nasalised vowel /i/ taken from /pit/ and /tip/ showed an increase in amplitude in F1, between F1 and F2 regions. The amplitude of the formants at F3 region was lower in the cleft group but did not differ from the control group as reported in previous studies. Although, the one-third-octave analysis has some potential in detecting hypernasality, the accuracy of the analysis compared to perceptual ratings of nasality was only moderate. Compared to nasometry, the diagnostic value of the one-third-octave analysis in detecting hypernasality was lower. / The overall findings suggest that, except for the Nasal Passage, the Oral Passage and the Set of Sentences developed in Malay using this systematic approach were culturally appropriate and valid for the assessment of nasality. Furthermore, by comparing two instrumental methods (nasometry and spectral analysis) with perceptual evaluation in a large number of cleft and typically developing children, the present thesis was able to demonstrate the clinical benefits of two recently proposed methods of spectral voice analyses and compare them to existing methods. Compared to spectral analysis, nasometry remains a superior method for assessing nasality. Threshold values that indicate abnormal nasality levels for the newly developed stimuli in Malay have been recommended.

Excessive nasal resonance in speech (hypernasality) is a disorder which may have negative communicative and social consequences for the speaker. Excessive nasal resonance is often associated with cleft lip and palate, velopharyngeal impairment, dysarthria or hearing impairment. Evaluation of hypernasality has proved to be a challenge in the clinic and in research. There are questions regarding the accuracy and reliability of auditory perceptual evaluations of nasal speech, and whether instrumental measures can be used to improve the reliability of clinical evaluation. There is also the question of whether clinical evaluation reflects the impact of hypernasality in a speaker’s everyday life. The purpose of this thesis was to evaluate the extent of reliability problems connected with auditory perceptual assessment of nasality in speech, to explore whether they might interfere with treatment decisions or have an impact in the everyday life of patients, and whether they can be effectively diminished by the use of nasometry. Speakers with cleft lip and palate or velopharyngeal impairment formed the basis of the clinical population used in this study. Speech samples from 52 of these speakers, along with samples from a reference population of 21 speakers who did not have cleft palate, velopharyngeal impairment or speech disorders were used in perceptual evaluation tasks. Fourteen speakers from the clinical population and 11 from the reference population also underwent nasometric evaluation. A further reference population of 220 children from three Swedish cities, whose ages were consistent with those used for clinical checks of children born with cleft palate were assessed with nasometry to establish normative data for the Nasometer™. Perceptual speech assessments were conducted on hyper- and hyponasality, as well as audible nasal air emission and/or nasal turbulence, using 5-point ordinal scales. Listeners were SLPs experienced in the evaluation of cleft palate speech, non-expert SLPs and untrained listeners. Listening assessments were performed from audio recorded speech samples assembled in random order. Nasometry measures were made on three speech passages each with specific phonetic content, using the Nasometer™, model II. Perceptual evaluation Results showed that for hypernasality assessment, 15% of hypernasality assessments had disagreements between expert SLPs that were potentially important for clinical decisions, as did 6% of assessments for audible nasal air emission and/or nasal turbulence. For nasality problems, a comparison of expert and untrained listeners showed that they generally agreed on which speakers were hypernasal and on the ranking of nasal speakers. All speakers that had been rated with moderate to severe hypernasality by expert listeners were considered by the untrained listeners as having a serious enough speech disorder to call for intervention. However, in the case of audible nasal air emission and/or nasal turbulence the expert listeners were more prone to notice this feature than the untrained listeners. Instrumental evaluation The development of normative values for the three Swedish passages for the NasometerTM (comparable to normative values in other languages) has provided a basis for use of instrumental measures in Swedish clinics, oral sentences mixed sentences nasal sentences. The measures showed no significant differences due to city, gender or age within an age range of 4-10 years. When nasometry measures were compared with perceptual evaluation of speech samples from the same speakers, all correlations were moderate to good for expert SLPs and non-expert SLPs. The difference between correlations was significantly higher for expert SLPs than for untrained listeners. Reliability figures for perceptual assessments for expert SLP listeners indicated that there were some cases where lack of reliability could affect clinical decision making. However, in the main, judgements of nasality problems made by clinicians had everyday validity. They reflected the impressions of the everyday listener, especially in regard to the need for intervention. The study also indicates that now that Swedish norms are available, the Nasometer™ might be useful as a complement to auditory perceptual clinical speech assessments in Swedish cleft palate clinics in order to improve reliability of clinical assessment.

A nasometria constitui um procedimento útil para a identificação dos distúrbios de ressonância causadas pela disfunção velofaríngea. Os estudos da nasalância em indivíduos com fissura de palato ou labiopalatina e fala normal são limitados e ainda não foram descritos dados exclusivamente de crianças. Este estudo teve como objetivo descrever os valores de nasalância obtidos com o nasômetro de crianças com fissura transforame unilateral reparada, falantes do português brasileiro, que apresentam fala normal. Foram selecionadas para este estudo 46 crianças de ambos os sexos, com idades variando entre 3 e 8 anos (\'X BARRA\' = 4 anos e 11 meses ± 1 ano e 1 mês), matriculados no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (HRAC-USP). Os resultados da nasalância indicaram: para amostras de fala compostas por fonemas orais de alta pressão \'X BARRA\' = 11,65% ± 2,33, para fonemas orais de baixa pressão \'X BARRA\' = 10,56% ± 5,49, para fonemas nasais e orais foi \'X BARRA\' = 36,95% ± 6,64 e para fonemas nasais \'X BARRA\' = 56,75% ± 9,9. Os valores de nasalância variaram de acordo com as amostras e o sexo não interferiu nestes valores. No presente estudo, os valores médios de nasalância das crianças com fissura labiopalatina e fala normal, foram semelhantes aos das crianças normais falantes do português brasileiro descritos na literatura. / Nasometry is an useful procedure for the identification of resonance disorders associated to velopharyngeal dysfunction. Studies addressing nasalance values for individuals with cleft lip and palate and normal speech are limited and nasométrica data exclusively based on children have not been reported. This study had the objective of describing nasalance values for children with operated unilateral complete cleft lip and palate, speakers of the brazilian portuguese, with normal speech. Participated in this study 46 children of both gender varying in age between 3 and 8 years (\'X BARRA\' = 4y11m SD = 1y1m), treated at the University of São Paulo Hospital for Rehabilitation of Craniofacial Anomalies (USP-HRAC). Findings revealed: mean nasalance score of 11.65% (SD = 2.33) for speech sample involving high pressure oral sounds; mean nasalance score of 10.56% (SD = 5.49,) for speech sample involving low pressure oral sounds; mean nasalance score of 36.95% (SD = 6.64) for speech sample involving oral and nasal sounds; mean nasalance score of 56.75% (SD = 9.9) for speech sample involving nasal sounds. Nasalance values varied according to speech samples with no effect due to gender. These findings agreed with previous data reported for children without cleft with normal speech speakers of brazilian portuguese.

A proposta deste estudo foi descrever os escores de nasalância de crianças mineiras e paulistas com nasalidade de fala normal, e comparar os escores de nasalância das crianças dos estados brasileiros de Minas Gerais e de São Paulo. Para isto foram obtidos escores de nasalância de quatro diferentes amostras de fala (\"papai\", \"papai pediu pipoca\", \"bebê\", e \"o bebê babou\") para cada criança. Participaram deste estudo 127 crianças (29 mineiras e 98 paulistas), pacientes do HRAC/USP, com fissura labiopalatina unilateral operada, e classificação perceptivo-auditiva de nasalidade de fala normal. Todas as crianças repetiram as quatro amostras de fala individualmente, e os dados foram coletados e analisados utilizando-se o nasômetro modelo 6200-3, fabricado pela Kay Elemetrics Corporation. A análise estatística foi realizada para investigar a influência da variação dialetal nos escores de nasalância, bem como para investigar a influência de outros falantes nas crianças estudadas e diferenças entre os gêneros. Os resultados indicaram média do escore de nasalância de 14,04% para a palavra \"papai\", de 16,38% para a frase \"papai pediu pipoca\", de 23,08% para a palavra \"bebê\", e de 22,55% para a frase \"o bebê babou\" para as crianças estudadas independentemente de seu estado de origem. Não houve diferença significante na média dos escores de nasalância entre as crianças mineiras e paulistas. Não houve diferença significante na média dos escores de nasalância entre as crianças que não sofreram influência de outros dialetos em sua fala e aqueles que poderiam ter sofrido esta influência. A variável gênero não demonstrou ser um fator que possa influenciar nos valores de nasalância para a população estudada. / The purpose of this study was to describe the nasalance scores in children with normal nasality from two different region of Brazil, Minas Gerais and São Paulo states. Mean nasalance scores were obtained for four different speech samples (\"papai\" - father, \"papai pediu pipoca\" - father requested popcorn, \"bebê\" - baby, and \"o bebê babou\" - the baby drooled) for each subject. One hundred twenty seven children (29 mineiras and 98 paulistas) with operated unilateral cleft lip and palate participated this study, all patients from HRAC/USP, with normal perceptual evaluation of nasality. All children repeated each of the four samples individually; and the data were collected and analyzed using the Nasometer model 6200-3 manufactured by Kay Elemetrics Corporation. Statistical analysis were performed in order to investigate the dialectal influence in nasalance scores, as well as to examine the influence of others in the subjects of this study and the differences in gender. The results indicated mean nasalance score of 14,04% for the word \"papai\", of 16,38% for the phrase \"papai pediu pipoca\", of 23,08% for the word \"bebê\", and of 22,55% for the phrase \"o bebê babou\". There was no significant difference in mean nasalance score between subjects from Minas Gerais and from São Paulo. There was no significant difference in mean nasalance score between subjects with and without influence from others dialects. There was no statistically significant effect of gender for the group of children in the present study.

A nasalidade da fala sofre influência de fatores como tamanho e formato da cavidade oral e da configuração da cavidade nasal. Nas deformidades dentofaciais são encontradas alterações no crescimento dos ossos da mandíbula e/ou maxila, estruturas diretamente relacionadas a estas cavidades. O objetivo deste estudo foi analisar a influência da deformidade dentofacial e o efeito da cirurgia ortognática nos escores de nasalância, em um acompanhamento de 6 meses de pós-operatório. Para o desenvolvimento deste estudo foram triados 146 indivíduos, de ambos os sexos, com idade superior a 18 anos, alfabetizados, sem distinção de raça e nível socioeconômico. Foram selecionados 91 indivíduos, sendo 53 com deformidades dentofaciais (23 classe II, idade média 27,4 anos; e 31 classe III, idade média 27,2 anos) e 37 sem deformidade dentofacial (grupo controle, idade média 25,3 anos). Os sujeitos foram submetidos inicialmente a uma entrevista e a uma avaliação miofuncional orofacial, em seguida, foi avaliado o fluxo aéreo nasal, por meio do espelho Milimetrado de Altmann®, e realizada a nasometria utilizando o Nasômetro II modelo 6400 (KayPENTAX, New Jersey - USA), durante a leitura de 10 frases padronizadas, do português brasileiro. Nos sujeitos com deformidades dentofaciais estes procedimentos foram repetidos em 3 períodos distintos do pós-operatório (P.O. I, II e III). Para a análise estatística foram utilizados os testes ANOVA two-way (p<0,05), para analisar o efeito da cirurgia nos escores de nasalância, e t de Student (p<0,05), para identificar em qual período ocorreu. No período pré-operatório os valores médios e os desvios-padrão dos escores de nasalância dos indivíduos controles e com deformidades dentofaciais classe II e III foram, respectivamente, 48.1% (5.9), 48.9% (6.7) e 45.4% (9.7) para o texto nasal e 12.0% (5.3), 14.9% (7.0) e 10.6% (5.4) para o texto oral, valores dentro dos padrões de normalidade para indivíduos brasileiros; a análise desses dados não mostrou diferença significativa entre os grupos. Quanto ao efeito da cirurgia ortognática nos escores de nasalância houve diferença estatisticamente significante para os fatores tempo-grupo no texto 6 oral, diferença evidenciada entre os períodos pré-operatório e P.O. III. Diante dos achados, pode-se concluir que o tipo de deformidade dentofacial pareceu não influenciar os escores de nasalância, já a cirurgia ortognática provocou efeito nesses escores, dentro de um período de 6 meses, porém sem alterar as características da nasalidade da fala, visto que os escores de nasalância se mantiveram dentro dos padrões de normalidade. / Factors such as size and shape of the oral cavity and the nasal cavity configuration may influence nasalance scores. In dentofacial deformities the abnormal growth of jaw and maxillary bones is directly related with changes in these cavities. The aim of this study was to analyze the influence of dentofacial deformity and the effect of orthognathic surgery on nasalance scores, during a 6-month post-operative followup. In order to develop this study, 146 individuals of both sexes, over 18 years older, literate, without distinction of race and socioeconomic status, were screened. Ninetyone individuals were selected, which 53 had dentofacial deformities (23 class II, mean age 27.4 years, and 31 class III, mean age 27.2 years) and 37 without dentofacial deformity (control group, mean age 25.3 years). The subjects were submitted to an interview and an orofacial myofunctional evaluation, then the nasal airflow was evaluated through the Altmann® graded mirror, and the nasometry was acquired with Nasometer II model 6400 (KayPENTAX, New Jersey - USA ) device, based on reading of 10 sentences standardized, from Brazilian Portuguese. In subjects with dentofacial deformities these procedures were repeated in 3 different postoperative periods (P.O. I, II and III). To analyze the surgery effect on nasalance scores it was used ANOVA two-way test (p<0.05) and Student\'s t test (p<0.05) was used to identify which period it occurred. In the preoperative period, the mean values and the standard deviations of the nasalance scores of the control group and groups with class II and III dentofacial deformities were, respectively, 48.1% (5.9), 48.9% (6.7) and 45.4% (9.7) for the nasal text and 12.0% (5.3), 14.9% (7.0) and 10.6% (5.4) for the oral text, values within normality standards for Brazilian individuals; analyzing these data no significant difference between the groups were found. About effect of orthognathic surgery on nasalance scores it was found a significant difference in time-group factor for the oral text and comparing the mean nasalance scores in the different periods, the difference was evidenced between the preoperative and PO III periods. Considering the findings, it can be concluded that the type of dentofacial 8 deformity did not appear to influence the nasalance scores, whereas the orthognathic surgery had an effect on these scores within a period of 6 months, but did not changing the nasality characteristics of the speech, because groups had scores within the normal range.

A proposta deste estudo foi descrever os escores de nasalância de crianças mineiras e paulistas com nasalidade de fala normal, e comparar os escores de nasalância das crianças dos estados brasileiros de Minas Gerais e de São Paulo. Para isto foram obtidos escores de nasalância de quatro diferentes amostras de fala (\"papai\", \"papai pediu pipoca\", \"bebê\", e \"o bebê babou\") para cada criança. Participaram deste estudo 127 crianças (29 mineiras e 98 paulistas), pacientes do HRAC/USP, com fissura labiopalatina unilateral operada, e classificação perceptivo-auditiva de nasalidade de fala normal. Todas as crianças repetiram as quatro amostras de fala individualmente, e os dados foram coletados e analisados utilizando-se o nasômetro modelo 6200-3, fabricado pela Kay Elemetrics Corporation. A análise estatística foi realizada para investigar a influência da variação dialetal nos escores de nasalância, bem como para investigar a influência de outros falantes nas crianças estudadas e diferenças entre os gêneros. Os resultados indicaram média do escore de nasalância de 14,04% para a palavra \"papai\", de 16,38% para a frase \"papai pediu pipoca\", de 23,08% para a palavra \"bebê\", e de 22,55% para a frase \"o bebê babou\" para as crianças estudadas independentemente de seu estado de origem. Não houve diferença significante na média dos escores de nasalância entre as crianças mineiras e paulistas. Não houve diferença significante na média dos escores de nasalância entre as crianças que não sofreram influência de outros dialetos em sua fala e aqueles que poderiam ter sofrido esta influência. A variável gênero não demonstrou ser um fator que possa influenciar nos valores de nasalância para a população estudada. / The purpose of this study was to describe the nasalance scores in children with normal nasality from two different region of Brazil, Minas Gerais and São Paulo states. Mean nasalance scores were obtained for four different speech samples (\"papai\" - father, \"papai pediu pipoca\" - father requested popcorn, \"bebê\" - baby, and \"o bebê babou\" - the baby drooled) for each subject. One hundred twenty seven children (29 mineiras and 98 paulistas) with operated unilateral cleft lip and palate participated this study, all patients from HRAC/USP, with normal perceptual evaluation of nasality. All children repeated each of the four samples individually; and the data were collected and analyzed using the Nasometer model 6200-3 manufactured by Kay Elemetrics Corporation. Statistical analysis were performed in order to investigate the dialectal influence in nasalance scores, as well as to examine the influence of others in the subjects of this study and the differences in gender. The results indicated mean nasalance score of 14,04% for the word \"papai\", of 16,38% for the phrase \"papai pediu pipoca\", of 23,08% for the word \"bebê\", and of 22,55% for the phrase \"o bebê babou\". There was no significant difference in mean nasalance score between subjects from Minas Gerais and from São Paulo. There was no significant difference in mean nasalance score between subjects with and without influence from others dialects. There was no statistically significant effect of gender for the group of children in the present study.

A nasometria constitui um procedimento útil para a identificação dos distúrbios de ressonância causadas pela disfunção velofaríngea. Os estudos da nasalância em indivíduos com fissura de palato ou labiopalatina e fala normal são limitados e ainda não foram descritos dados exclusivamente de crianças. Este estudo teve como objetivo descrever os valores de nasalância obtidos com o nasômetro de crianças com fissura transforame unilateral reparada, falantes do português brasileiro, que apresentam fala normal. Foram selecionadas para este estudo 46 crianças de ambos os sexos, com idades variando entre 3 e 8 anos (\'X BARRA\' = 4 anos e 11 meses ± 1 ano e 1 mês), matriculados no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (HRAC-USP). Os resultados da nasalância indicaram: para amostras de fala compostas por fonemas orais de alta pressão \'X BARRA\' = 11,65% ± 2,33, para fonemas orais de baixa pressão \'X BARRA\' = 10,56% ± 5,49, para fonemas nasais e orais foi \'X BARRA\' = 36,95% ± 6,64 e para fonemas nasais \'X BARRA\' = 56,75% ± 9,9. Os valores de nasalância variaram de acordo com as amostras e o sexo não interferiu nestes valores. No presente estudo, os valores médios de nasalância das crianças com fissura labiopalatina e fala normal, foram semelhantes aos das crianças normais falantes do português brasileiro descritos na literatura. / Nasometry is an useful procedure for the identification of resonance disorders associated to velopharyngeal dysfunction. Studies addressing nasalance values for individuals with cleft lip and palate and normal speech are limited and nasométrica data exclusively based on children have not been reported. This study had the objective of describing nasalance values for children with operated unilateral complete cleft lip and palate, speakers of the brazilian portuguese, with normal speech. Participated in this study 46 children of both gender varying in age between 3 and 8 years (\'X BARRA\' = 4y11m SD = 1y1m), treated at the University of São Paulo Hospital for Rehabilitation of Craniofacial Anomalies (USP-HRAC). Findings revealed: mean nasalance score of 11.65% (SD = 2.33) for speech sample involving high pressure oral sounds; mean nasalance score of 10.56% (SD = 5.49,) for speech sample involving low pressure oral sounds; mean nasalance score of 36.95% (SD = 6.64) for speech sample involving oral and nasal sounds; mean nasalance score of 56.75% (SD = 9.9) for speech sample involving nasal sounds. Nasalance values varied according to speech samples with no effect due to gender. These findings agreed with previous data reported for children without cleft with normal speech speakers of brazilian portuguese.

A nasalidade da fala sofre influência de fatores como tamanho e formato da cavidade oral e da configuração da cavidade nasal. Nas deformidades dentofaciais são encontradas alterações no crescimento dos ossos da mandíbula e/ou maxila, estruturas diretamente relacionadas a estas cavidades. O objetivo deste estudo foi analisar a influência da deformidade dentofacial e o efeito da cirurgia ortognática nos escores de nasalância, em um acompanhamento de 6 meses de pós-operatório. Para o desenvolvimento deste estudo foram triados 146 indivíduos, de ambos os sexos, com idade superior a 18 anos, alfabetizados, sem distinção de raça e nível socioeconômico. Foram selecionados 91 indivíduos, sendo 53 com deformidades dentofaciais (23 classe II, idade média 27,4 anos; e 31 classe III, idade média 27,2 anos) e 37 sem deformidade dentofacial (grupo controle, idade média 25,3 anos). Os sujeitos foram submetidos inicialmente a uma entrevista e a uma avaliação miofuncional orofacial, em seguida, foi avaliado o fluxo aéreo nasal, por meio do espelho Milimetrado de Altmann®, e realizada a nasometria utilizando o Nasômetro II modelo 6400 (KayPENTAX, New Jersey - USA), durante a leitura de 10 frases padronizadas, do português brasileiro. Nos sujeitos com deformidades dentofaciais estes procedimentos foram repetidos em 3 períodos distintos do pós-operatório (P.O. I, II e III). Para a análise estatística foram utilizados os testes ANOVA two-way (p<0,05), para analisar o efeito da cirurgia nos escores de nasalância, e t de Student (p<0,05), para identificar em qual período ocorreu. No período pré-operatório os valores médios e os desvios-padrão dos escores de nasalância dos indivíduos controles e com deformidades dentofaciais classe II e III foram, respectivamente, 48.1% (5.9), 48.9% (6.7) e 45.4% (9.7) para o texto nasal e 12.0% (5.3), 14.9% (7.0) e 10.6% (5.4) para o texto oral, valores dentro dos padrões de normalidade para indivíduos brasileiros; a análise desses dados não mostrou diferença significativa entre os grupos. Quanto ao efeito da cirurgia ortognática nos escores de nasalância houve diferença estatisticamente significante para os fatores tempo-grupo no texto 6 oral, diferença evidenciada entre os períodos pré-operatório e P.O. III. Diante dos achados, pode-se concluir que o tipo de deformidade dentofacial pareceu não influenciar os escores de nasalância, já a cirurgia ortognática provocou efeito nesses escores, dentro de um período de 6 meses, porém sem alterar as características da nasalidade da fala, visto que os escores de nasalância se mantiveram dentro dos padrões de normalidade. / Factors such as size and shape of the oral cavity and the nasal cavity configuration may influence nasalance scores. In dentofacial deformities the abnormal growth of jaw and maxillary bones is directly related with changes in these cavities. The aim of this study was to analyze the influence of dentofacial deformity and the effect of orthognathic surgery on nasalance scores, during a 6-month post-operative followup. In order to develop this study, 146 individuals of both sexes, over 18 years older, literate, without distinction of race and socioeconomic status, were screened. Ninetyone individuals were selected, which 53 had dentofacial deformities (23 class II, mean age 27.4 years, and 31 class III, mean age 27.2 years) and 37 without dentofacial deformity (control group, mean age 25.3 years). The subjects were submitted to an interview and an orofacial myofunctional evaluation, then the nasal airflow was evaluated through the Altmann® graded mirror, and the nasometry was acquired with Nasometer II model 6400 (KayPENTAX, New Jersey - USA ) device, based on reading of 10 sentences standardized, from Brazilian Portuguese. In subjects with dentofacial deformities these procedures were repeated in 3 different postoperative periods (P.O. I, II and III). To analyze the surgery effect on nasalance scores it was used ANOVA two-way test (p<0.05) and Student\'s t test (p<0.05) was used to identify which period it occurred. In the preoperative period, the mean values and the standard deviations of the nasalance scores of the control group and groups with class II and III dentofacial deformities were, respectively, 48.1% (5.9), 48.9% (6.7) and 45.4% (9.7) for the nasal text and 12.0% (5.3), 14.9% (7.0) and 10.6% (5.4) for the oral text, values within normality standards for Brazilian individuals; analyzing these data no significant difference between the groups were found. About effect of orthognathic surgery on nasalance scores it was found a significant difference in time-group factor for the oral text and comparing the mean nasalance scores in the different periods, the difference was evidenced between the preoperative and PO III periods. Considering the findings, it can be concluded that the type of dentofacial 8 deformity did not appear to influence the nasalance scores, whereas the orthognathic surgery had an effect on these scores within a period of 6 months, but did not changing the nasality characteristics of the speech, because groups had scores within the normal range.