Orthognathic speech pathology: Understanding how jaw disharmonies and their surgical correction influence speech

正颌言语病理学：了解下颌不和谐及其手术矫正如何影响言语

• 批准号: 10456146
• 负责人: Laura Anne Jacox
• 金额: $ 16.7万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10456146
• 关键词: Acoustics; Address; Alveolar; Alveolus; American; Anatomy; Anterior; Articulation; Arts; Award; Biology; Bite; Caring; Clinical; Communication; Complement; Consensus; Craniofacial Abnormalities; Data; Dental Schools; Development; Disease; Doctor of Philosophy; Enrollment; Ensure; Esthetics; Evaluation; Evidence based treatment; Face; Foundations; General Population; Generations; Gestures; Grant; Growth; High Prevalence; Impairment; Investigation; Jaw; Knowledge; Language; Lead; Link; Long-Term Effects; Longterm Follow-up; Malocclusion; Mastication; Medicine; Mentors; Movement; Open Bite; Operative Surgical Procedures; Oral Surgical Procedures; Oral cavity; Orthodontic; Orthodontics; Participant; Pathologic; Pathologist; Pathology; Patients; Pattern; Population; Positioning Attribute; Postoperative Period; Posture; Property; Provider; Publishing; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Records; Research; Schools; Science; Scientist; Severities; Speech; Speech Disorders; Speech Pathology; Speech Sound; Speech Therapy; Syndrome; Technology; Testing; Time; Tongue; Tooth structure; Training; Training Activity; Treatment outcome; base; dentofacial; design; evidence base; evidence based guidelines; experimental study; follow-up; improved; operation; orthognathic; programs; recruit; skills; sound; spelling; standard of care; ultrasound

ABSTRACT Scientific Approach: Patients with severe dentofacial disharmonies (DFD; jaw disharmonies) seek orthognathic surgery and orthodontic care to address issues with mastication, esthetics and speech. Preliminary data from thousands of DFD patients generated by our colleagues at UNC-CH indicate speech concerns surpass impaired chewing function as a motivator for surgery. Due to limited studies, we, as providers, are unable to give evidence- based recommendations as to whether our orthodontic and surgical interventions will address speech disorders associated with DFD. Despite limited data, patients undergo invasive jaw surgery in hopes of speech improvement. To address this gap in knowledge, we have gathered surgical records and pre-operative audio recordings of patients with DFD to quantitatively characterize their speech. In this proposal, we present preliminary data identifying anatomical thresholds for significant articulation errors. Based on these data, we hypothesize that speech distortions correlate with severity of anterior-posterior and vertical jaw disharmonies, and that corrective surgery yields long-term improvement in speech. We propose the following aims to address this hypothesis and explore the relationship between correction of jaw disharmonies and speech. Aim 1: To examine the relationship between underbite (Class III) and open bite jaw disharmonies, and speech distortion. Aim 2: To assess short- and long-term effects of corrective orthognathic surgery on speech distortion in patients with underbite and open bite. Training approach: Dr. Jacox is a dual-trained clinician-scientist, who completed dental school in parallel with graduate school at Harvard School of Dental Medicine (HSDM- DMD) and Graduate School of Arts and Sciences (GSAS- PhD). In addition, she is a certified diplomate of the American Board of Orthodontics. Her research program and focus of this application was inspired by a patient seeking treatment `to help her talk normally', whereby an evidence-based treatment option was not clear. The mentoring plan for this K08 award is designed to ensure Dr. Jacox will be a well-rounded and successful independent clinician-scientist following completion of the activities in this proposal. Dr. Jacox has assembled a strong mentoring team to guide her professional development and the establishment of her independent research program. Two co-mentors and four consultants from diverse yet appropriate scientific and professional backgrounds will assist in the completion of the training and scientific activities. Scientific interactions as well as didactic training in speech science and technologies of speech science will add to Dr. Jacox's strong foundation in clinical orthodontics and the biology of dentofacial disharmonies. These growth opportunities will allow for successful completion of the proposed experiments, while the professional development activities will complement the training activities and provide Dr. Jacox with skills necessary to thrive in academics and launch her independent research program.

抽象的 科学方法：患有严重牙颌不和谐（DFD；下颌不和谐）的患者寻求正颌手术 手术和正畸护理，以解决咀嚼、美观和言语问题。初步数据来自 我们在 UNC-CH 的同事发现的数千名 DFD 患者表明，言语问题超过了受损患者 咀嚼功能作为手术的动力。由于研究有限，我们作为提供者无法提供证据- 关于我们的正畸和手术干预是否能解决言语障碍的建议 与 DFD 相关。尽管数据有限，患者仍接受侵入性颌骨手术，希望能够说话 改进。为了解决这一知识差距，我们收集了手术记录和术前音频 DFD 患者的录音以定量描述他们的言语特征。在本提案中，我们提出 初步数据确定重大关节错误的解剖阈值。根据这些数据，我们 假设言语扭曲与前后颌和垂直下颌的严重程度相关 不和谐，并且矫正手术可以带来言语的长期改善。我们建议 以下旨在解决这一假设并探讨矫正颌骨不和谐之间的关系 和演讲。目标 1：检查反颌（III 类）和开牙颌不和谐之间的关系， 和言语失真。目标 2：评估矫正正颌手术对患者的短期和长期影响 反颌和开牙合患者的言语扭曲。 培训方式：Jacox 博士是一位接受过双重培训的临床医生兼科学家，他同时完成了牙科学校的学习 哈佛大学牙科医学院 (HSDM-DMD) 和艺术与科学研究生院 （GSAS-博士）。此外，她还是美国正畸委员会认证的外交官。她的研究 该应用程序的计划和重点受到一位寻求治疗“帮助她说话”的患者的启发 通常情况下”，基于证据的治疗方案尚不明确。本次K08的辅导计划 该奖项旨在确保 Jacox 博士成为一名全面且成功的独立临床医生科学家 完成本提案中的活动后。 Jacox博士组建了强大的导师团队来指导 她的专业发展和独立研究计划的建立。两位共同导师和 来自不同但适当的科学和专业背景的四名顾问将协助完成 培训和科学活动。科学互动以及言语科学和 言语科学技术将为 Jacox 博士在临床正畸学和生物学方面奠定坚实的基础 牙齿面部不和谐。这些增长机会将有助于成功完成拟议的 实验，而专业发展活动将补充培训活动并为博士提供机会。 雅科克斯拥有在学术领域蓬勃发展并启动独立研究项目所需的技能。