PubMed · 7927590
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I Singh, G Gathwala, R Pathania, J Singh, S P Yadav. Hypertrophic tonsils causing articulation defect.. https://doi.org/10.1007/bf02753572
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Acute bilateral tongue palsy is a rare clinical presentation. We report one such case caused by skull base metastases from prostate cancer. There were no other cranial nerves involved or associated neurological deficit. Mild improvement was seen following radiation therapy. We review the anatomy of the nerve and differential diagnosis of its disfunction.
We present the symptomatology of a complex articulation-related dyskinesia of the pharynx with intermittent functional velopharyngeal insufficiency. It became permanent gradually after a writer's cramp had remitted without therapy. No final nosologic assignment can be made on the basis of the described observations in the individual case. The development of the disease in the 56-year old male patient ended in occupational disability. It suggests manifestation of psychopathological events in the patient's life history of threshold situations by premorbid psychic vulnerability. The possibility of the etiopathologic interaction of emotional and neurological factors cannot be excluded. However, therapy with local botulinum toxin injections proved to be just as unsuccessful as logopedic treatment.
The article comprises the proposal made by the Cleft Palate Committee of IALP to standardize the parameters of the speech and hearing evaluation in individuals with cleft palate/velopharyngeal incompetence (CP/VPI). The suggested parameters are the following: nasal resonance, nasal escape, articulation and its disorders, facial grimacing, speech intelligibility, patient teachability, expressive language and voice. The authors recommend a five-point scale description system, which can be used also for assessment of hearing, velopharyngeal competence and other attributes of the CP/VPI individual. The most important diagnostic procedures are: X-ray (video/cinefluoroscopy), nasopharyngoscopy, nasometry; in dubious cases it is also fundamental to clarify the etiology with electrophysiological methods. The utilization of this proposal might contribute to a more accurate diagnosis and a more effective treatment on an international basis.