Skip to main content
SpringerLink
Log in

Palatographische Verfahren für Diagnostik und Therapie

Palatographic procedures for diagnosis and therapy

  • HNO-Praxis
  • Published:
HNO Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Die Bewegung der Zunge während der Artikulation kann nur bedingt direkt visuell inspiziert werden. Dadurch ist es schwierig, die Relation der aktuellen Zungenposition zu anderen an der Artikulation teilhabenden Strukturen zu bewerten. Dies ist jedoch für die Grundlagenforschung und klinische Diagnostik wichtig, z. B. zur Beurteilung der resultierenden Resonanzräume. Bildgebende palatographische Verfahren versprechen einen Einblick in die Artikulationsvorgänge und somit prinzipiell auch in Pathomechanismen. Hier wird ein Überblick über die Palatographie und eine kritische Würdigung für die sprachdiagnostische Praxis gegeben.

Methodik

Es wurde eine selektive Literaturrecherche (NHS EED, HTA, DARE, Clinical Trials, Medline-PubMed, DARE, HTA Cochrane Reviews) durchgeführt.

Ergebnisse

Zwar wurden 42 deskriptive Studien gefunden, jedoch keine einzige prospektive randomisierte Studie hinsichtlich der diagnostischen oder therapeutischen Wertigkeit.

Diskussion

Palatographische Verfahren geben Hinweise zu nicht direkt beobachtbaren artikulationsmotorischen Abläufen. Nicht hinreichend untersucht ist, ob das jeweilige Verfahren den Artikulationsablauf so beeinträchtigt, dass eine klinisch relevante Aussage nicht mehr möglich ist. Dringend erforderlich sind Studien mit hohem Evidenzgrad zur Sensitivität und Spezifität der Palatographie in der Diagnose sowie Studien zur Effektivität und Effizienz beim Einsatz als therapeutisches Verfahren.

Abstract

Background

Visual diagnosis of the tongue’s articulatory movements in many speech sounds is hindered by the inaccessibility of the oral cavity during speech. Therefore, it is difficult to assess the actual tongue position in relation to other structures involved. Such an assessment is useful for fundamental research as well as medical diagnoses, i.e. evaluation of corresponding resonating cavities. Palatographic imaging methods promise to deliver insight into articulatory sequences and should consequently expose underlying pathological mechanisms, which potentially makes it a useful tool for the diagnosis of speech. This article aims to review the different palatographic procedures and evaluate their eligibility as a diagnostic tool.

Methods

A selective literature search (NHS EED, HTA, DARE, Clinical Trials, Medline-PubMed, DARE, HTA Cochrane Reviews) has been carried out.

Results

A total of 42 descriptive studies were found, but not a single prospective randomised study regarding the diagnostic or therapeutic value of palatographic imaging methods was among these results.

Discussion

Palatographic procedures provide insight into non-visible articulatory movements. It has not been evaluated sufficiently, however, whether the individual examination procedures impair the articulatory movement in such a way that no relevant clinical assessment can be carried out. Studies with a high level of evidence concerning the sensitivity and specificity of palatography as a diagnostic instrument, as well as studies regarding the effectiveness and efficiency as a therapeutic approach are needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Notes

  1. Die Zungenspitze biegt sich bei der Artikulation etwas nach oben zurück und erzeugt einen postalveolaren Kontakt [32].

  2. Zu beziehen z. B. über die Fa. Ortho Technology, Tampa/FL, USA.

  3. Laut, der durch die Verengung des Artikulationskanals und die dadurch herbeigeführte Reibung (Friktion) erzeugt wird (auch: Reibelaut).

  4. Derzeit werden Modelle von 4 Firmen kommerziell angeboten: Reading EPG 3 (Reading, GB), WinEPG und PTU von Articulate Instruments Ltd. (East Lothian, UK), Rion DP01 der Rion Corporation (Tokio, Japan) und ein „Palatometer“ von KayPentax (Lincoln Park, NJ, USA).

Literatur

  1. Dagenais PA (1995) Electropalatography in the treatment of articulation/phonological disorders. J Commun Disord 28:303–329

    Article  PubMed  CAS  Google Scholar 

  2. Moher D, Liberati A, Altmann DG (2009) Preferred reporting items for systematic reviews and meta analyses: the PRISMA statement. PLoS Med 6

  3. Ladefoged P (1957) Use of palatography. J Speech Hear Disord 22:764–774

    PubMed  CAS  Google Scholar 

  4. Murdoch BE, Goozee JV, Veidt M et al (2004) Introducing the pressure-sensing palatograph – the next frontier in electropalatography. Clin Linguist Phon 18:433–445

    Article  PubMed  Google Scholar 

  5. Hamlet SL (1988) Speech compensation for prosthodontically created palatal asymmetries. J Speech Hear Res 31:48–53

    PubMed  CAS  Google Scholar 

  6. Flege JE, Fletcher SG, Homiedan A (1988) Compensating for a bite block in /s/ and /t/ production: palatographic, acoustic, and perceptual data. J Acoust Soc Am 83:212–228

    Article  PubMed  CAS  Google Scholar 

  7. Hamlet SL, Stone M (1982) Speech adaptation to dental prostheses: the former lisper. J Prosthet Dent 47:564–569

    Article  PubMed  CAS  Google Scholar 

  8. Suzuki N, Sakuma T, Michi K et al (1981) The articulatory characteristics of the tongue in anterior openbite: observation by use of dynamic palatography. Int J Oral Surg 10:299–303

    PubMed  CAS  Google Scholar 

  9. Kawauchi M, Kanamori Y, Sachdeva R et al (1992) The dynamic dento-palatography system: a new approach for evaluating speech. J Biomed Eng 14:163–168

    Article  PubMed  CAS  Google Scholar 

  10. Reinicke C, Obijou N, Trankmann J (1998) The palatal shape of upper removable appliances. influence on the tongue position in swallowing. J Orofac Orthop 59:202–207

    Article  PubMed  CAS  Google Scholar 

  11. Horn H, Kuhnast K, Axmann-Krcmar D et al (2004) Influence of orofacial dysfunctions on spatial and temporal dimensions of swallowing movements. J Orofac Orthop 65:376–388

    Article  PubMed  Google Scholar 

  12. Engelke W, Engelke D, Schwestka R (1990) Clinical and instrumental examination of tongue motor function. Dtsch Zahnarztl Z 45:S11–S16

    PubMed  CAS  Google Scholar 

  13. Engelke W, Schonle PW, Engelke D (1990) 2 Objective procedures for the assessment of motor functions after surgery of the tongue and velum. Dtsch Z Mund Kiefer Gesichtschir 14:348–358

    PubMed  CAS  Google Scholar 

  14. Michi K, Suzuki N, Yamashita Y et al (1986) Visual training and correction of articulation disorders by use of dynamic palatography: serial observation in a case of cleft palate. J Speech Hear Disord 51:226–238

    PubMed  CAS  Google Scholar 

  15. Korbmacher HM, Schwan M, Berndsen S et al (2004) Evaluation of a new concept of myofunctional therapy in children. Int J Orofacial Myology 30:39–52

    PubMed  Google Scholar 

  16. Tränkmann J, Rixe K (1995) Follow-up study of dyskinesia-induced dysgnathias following myofunctional therapy. Fortschr Kieferorthop 56:67–76

    Article  PubMed  Google Scholar 

  17. Case JL (1975) Palatography and myo-functional therapy. Int J Oral Myol 1:65–71

    PubMed  CAS  Google Scholar 

  18. Wictorin L, Agnello J (1970) Speech pattern changes during edentulous and denture conditions. I. Palatographic Study. Acta Odontol Scand 28:729–737

    Article  PubMed  CAS  Google Scholar 

  19. Ylppo A, Sovijarvi A (1962) Sonagraphic and palatographic studies of full denture, half denture, and edentulous eases. Acta Odontol Scand 20:257–299

    Article  PubMed  CAS  Google Scholar 

  20. Traill A (1977) On so-called ‚lateral [s]’: some observations from palatography and spectrography. S Afr J Commun Disord 24:3–21

    PubMed  CAS  Google Scholar 

  21. Orthmann W (1968) On an improved palatographic procedure. contribution to the relationship between dentistry and phonetics. DDZ 22:399–404

    PubMed  CAS  Google Scholar 

  22. Herrmann TPD, Grabowski JPD (Hrsg) (2003) Enzyklopädie der Psychologie. Theorie und Forschung. Sprache. Band 1: Sprachproduktion. Hogrefe, Göttingen u.a

    Google Scholar 

  23. Ladefoged P (2003) Phonetic data analysis. Blackwell Publishing, Malden

  24. Hardcastle WJ, Jones W, Knight C et al (1989) New developments in electropalatography: a state-of-the-art report. Clin Linguist Phon 3:1–38

    Article  Google Scholar 

  25. Gibbon F, Dent H, Hardcastle W (1993) Diagnosis and therapy of abnormal alveolar stops in a speech-disordered child using electropalatography. Clin Linguist Phon 7:247–267

    Article  Google Scholar 

  26. Hardcastle WJ, Gibbon F (1997) Electropalatography and its clinical applications. Instrum Clin Phon 149–193

  27. Gibbon F, Nicolaidis K (1999) Palatography. In: Hardcastle WJ, Hewlett N (eds) Coarticulation – theory, data, techniques. Cambridge University Press, Cambridge, UK

  28. Carstens Medizinelektronik GmbH (2007) Homepage. http://www.articulograph.de/, Stand 2010

  29. Li F, Edwards J, Beckman ME (2009) Contrast and covert contrast: the phonetic development of voiceless sibilant fricatives in English and Japanese toddlers. J Phon 37:111–124

    Article  PubMed  CAS  Google Scholar 

  30. Goldstein P, Ziegler W, Vogel M et al (1994) Combined palatal-lift and EPG-feedback therapy in dysarthria: a case study. Clin Linguist Phon 8:201–218

    Article  Google Scholar 

  31. Morgan BR (1993) Measuring segmental timing in pathological speech using electropalatography. Clin Linguist Phon 7:275–283

    Article  Google Scholar 

  32. Grassegger H (2001) Phonetik – Phonologie. Schulz-Kirchner, Idstein

Download references

Danksagung

Für die Bereitstellung des Bildmaterials danken wir der Fa. Carstens Medizinelektronik GmbH, Bovenden (http://www.articulograph.de), der Fa. Articulate Instruments Ltd, East Lothian, UK (http://www.articulateinstruments.com), sowie Dougie Barnett, Queen-Margaret-Universität, Edinburgh, UK, und Herrn Dr. Christian Geng, GWZ 4/5-2(A1).

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg–Straße 1, 30625, Hannover, Deutschland

    S. Meyer &  M. Ptok

Authors
  1. S. Meyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Ptok
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Ptok.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meyer, S., Ptok, M. Palatographische Verfahren für Diagnostik und Therapie. HNO 59, 385–392 (2011). https://doi.org/10.1007/s00106-010-2252-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00106-010-2252-1

Schlüsselwörter

Keywords

Search

Navigation