Search Results (15)

Background: Obstructive Sleep Apnea (OSA) is commonly treated with CPAP, though low patient compliance often limits its long-term use. Surgical alternatives, such as Barbed Pharyngoplasty, have been developed to address retro-velar collapse. A recent technique, Barbed Stayed Bridge Pharyngoplasty (BSBP), aims to preserve oropharyngeal anatomy while enhancing airway stability. This study evaluates the immediate postoperative outcomes and patient discomfort following BSBP for OSA. Material and Method: Thirty patients (mean age 40.7 ± 8.9 years; BMI 25.9 ± 1.7) underwent BSBP at Sapienza University of Rome between January 2022 and January 2024. Inclusion criteria included AHI 15–30, BMI ≤ 35, and specific DISE findings. Postoperative outcomes were evaluated using polysomnographic data (AHI, ODI), the Epworth Sleepiness Scale (ESS), pain scores (VAS), edema grading (Ezzat score), and the PPOPS questionnaire. Follow-ups were performed at 12, 24, and 48 h; 1 month; and 6 months postoperatively. Results: Thirty patients (average age 40.7) with mild to moderate OSA underwent surgery. After six months, there was a significant reduction in AHI (from 23.4 ± 2.1 to 7.2 ± 2.6) and ODI (from 21.0 ± 4.1 to 6.5 ± 2.1), along with a statistically significant improvement in the Epworth Sleepiness Scale. Postoperative pain (VAS) decreased from 3.0 ± 1.5 at 12 h to 0.2 ± 0.5 at one month, and edema (Ezzat score) decreased from 2.0 ± 0.6 at 12 h to 0.0 ± 0.0 at one month, both with significant differences. The PPOPS questionnaire scores remained relatively stable, with mean values of 4.9 ± 2.3 at 12 h, 2.7 ± 1.6 at 24 h, 1.2 ± 1.1 at 48 h, and 0.5 ± 0.7 at one month, showing statistically significant change (p < 0.005). No postoperative bleeding occurred. According to Sher’s criteria, the procedure was consistently effective. Conclusions: BSBP significantly reduces AHI and ODI, demonstrating effective symptom resolution with minimal discomfort and rapid recovery. These results suggest that BSBP may be a viable, less invasive surgical technique for OSA surgeries. Full article

This study investigates the initial consonant system of the Yongle Nanzang 永乐南藏, the second officially printed edition of the Chinese Buddhist canon of the Ming dynasty, and its relationship to the Qishazang 磧砂藏. Based on a digital and quantitative analysis of 27,832 phonetic entries—including Fanqie 反切 and Zhiyin 直音—we apply correlation coefficients (with significance tests), hierarchical clustering, and data mining methods. The results show the following: (1) In the labial series, contrasts between aspirated and unaspirated sounds are weak; Bang 幫 and Pang 滂 are occasionally confused; and Fei 非 and Fu 敷 are merged. Voiced and voiceless initials are sometimes mixed, but full devoicing has not occurred. (2) In the coronal series, Duan Zu 端組 shows high internal interchange and Zhi Zu 知組 tends to mix with Zhang Zu 章組 and Zhuang Zu 莊組. (3) In the sibilant and affricate series, Jing 精 and Zhuang 莊 are merged; Chuan 船 and Shan 禪 also merge, while Cong 從 and Xie 邪 only occasionally alternate. (4) In the velar and laryngeal series, fully voiced Qun 羣 is close to voiceless initials, while Yun 云 and Yi 以 are closely related. Nasal and lateral initials maintain independence. The findings suggest that Yongle Nanzang 永乐南藏 is not a direct reprint of the Qishazang 磧砂藏, but rather a revised edition adapted to editorial or regional considerations. This study demonstrates the value of digital phonological methods in historical phonology and the significance of the Ming–Qing Chinese Buddhist canon. Full article

This study investigates the development of the lateral fricatives and affricates, to which we jointly refer as ‘lateral obstruents’, in Nguni (S40) languages of Southern Africa. These lateral obstruents, which include /ɬ, ⁿɬ, ɮ, ⁿɮ, k͡ʟ̝̊/, are rare in the Bantu language family, and are not reconstructed for Proto-Bantu. Lateral obstruents are also rare cross-linguistically. They do occur, however, in four sub-branches of Southern Bantu: Shona, Sotho-Tswana, Nguni, and Tsonga. In this paper, we study how Southern Bantu could have acquired such a large inventory of cross-linguistically rare phonemes by investigating their development in Nguni languages, a large but closely related cluster of languages in which lateral obstruents are very frequent. We analyze published data from nine Nguni languages, including languages for which the only available descriptions are dated or of limited scope, in which case we carefully assess the data and their analysis. On the basis of this large database, we show which lateral obstruents are used in Nguni, and the vocabulary in which they occur. Applying the Comparative Method, we show that alveolar lateral obstruents can be reconstructed to Proto-Nguni, where they are the regular reflex of Proto-Bantu palatals *c and *j. The velar lateral affricate, in contrast, cannot be reconstructed to Proto-Nguni, and finds its origin in loanwords, for example, from Khoe languages, where it is used as a click replacement strategy. As a result, we conclude that both inheritance and contact played a role in the development of lateral obstruents in Nguni, likely combined in the case of alveolar lateral obstruents. In order to better understand the contact history, we evaluate existing hypothesized contact scenarios to account for the presence of lateral obstruents in Southern Bantu or Nguni. Given that alveolar lateral obstruents result from a regular sound change, contact does not seem to be as prominent in the development of lateral obstruents as has been proposed before in the literature. This study lays the groundwork for future research into lateral obstruents in Southern Bantu. Full article

While both French and Spanish have complex onsets, the languages differ in the variety and distribution of clusters allowed as well as in the realization of voiced stops. The present study examines the effects of C1 voicing, place of articulation, and language on the production of word-initial /pl bl kl gl/ using a combination of electropalatographic (C1 and C2 linguopalatal contact and timing) and acoustic measures (duration and relative intensity) from 4 French and 7 Spanish speakers. Certain between-language similarities and differences in the effects of voicing and place on intergestural timing were observed. In particular, (1) both languages showed more overlap in clusters where C1 was velar rather than labial; (2) the effect of voicing (more overlap in clusters with a voiced C1) was restricted to French; and (3) lateral duration was unaffected by C1 place or voicing, while C1 duration was strongly affected by stress and voicing in Spanish alone given the approximantization of voiced stops. These results contribute to a better understanding of the general mechanisms and language-specific patterns of intergestural coordination in onset clusters and add to the growing body of articulatory work on these complex structures in Romance languages. Full article

The present study reports tongue configuration data recorded with ultrasound for two sets of consonant sequences uttered by five native Catalan speakers. Articulatory data for the onset cluster pairs [kl]-[ɣl] and [kɾ]-[ɣɾ], and also for [l#k]-[l#ɣ] and [r#k]-[r#ɣ], analyzed in the first part of the investigation revealed that, as a general rule, the (shorter) velar approximant is less constricted than the (longer) voiceless velar stop at the velar and palatal zones while exhibiting a more retracted tongue body at the pharynx. These manner of articulation-dependent differences may extend into the preceding liquid. Data for [k#l]-[kl] and [k#r]-[kɾ] dealt with in the second part of the study show that the velar is articulated with more tongue body retraction for [k#l] vs. [kl] and for [k#r] vs. [kɾ], and with a higher tongue dorsum for [k#l] vs. [kl] and the reverse for [k#r] vs. [kɾ]. Therefore, clusters are produced with a more extreme lingual configuration across a word boundary than in syllable-onset position, which at least in part may be predicted by segmental factors for the [k#r]-[kɾ] pair. These articulatory data are compared with duration data for all sequence pairs. Full article

This paper examines patterns of gemination in child Egyptian Arabic, with a focus on how gemination functions as a repair strategy, using data from the Egyptian Arabic Salama Corpus. The findings show that the phonological development of Egyptian Arabic-speaking children of geminated consonants correlates with previously established developmental stages. Initial stages involve the acquisition of labial geminates, transitioning through an increased use of alveolar and velar geminates, to the acquisition of rhotic and lateral geminates in later phases. The findings also suggest that gemination is not merely a phonetic phenomenon in child phonology, but also shows the children’s awareness of the phonology of the dialect, especially the moraicity of vowels and consonants. Full article

Mai-Ndombe is one of the southwestern provinces of the Democratic Republic of Congo. Ecologically, it can be characterised as a transition zone between a moist, broadleaf rainforest ecotone in the north and shrubland/savannah areas in the south. Linguistically, Mai-Ndombe, along with the rest of southwestern Congo all the way down to the border with Angola, is among the least well-surveyed areas of the planet. Within its borders, several different Bantu (Guthrie’s zones B, C, and H) varieties are spoken, near the newly identified West-Coastal Bantu homeland, itself a hot spot of phonological diversity unlike any other in the West-Coastal Bantu domain. Phonetic and phonological accounts of its languages are particularly lacking (apart from impressionistic “grey literature” reports which seldom comply with the standards of present-day phonetic and phonological inquiry). This gap is particularly concerning as Mai-Ndombe is also an area of great anthropological diversity, with numerous hunter-gatherer Twa communities living deep in its eastern and northern forests. Their lects, collectively known as Lotwa, are severely endangered, as they face the threats of social stigma and the growing use of national and regional linguae francae. As part of the author’s doctoral project (still underway), phonetic data were collected in the area between May and July 2021, specifically in Inongo (the provincial capital) and Nioki. The present contribution is intended as a brief note on the relevant results produced so far, mainly bearing on the analysis of some phenomena of interest in the languages of the region, including Sakata rhotics and labial–velars and the presence of unusual trilling/flapping realisations in Lotwa. The picture yielded by this preliminary exploration is one of striking phonetic and phonological variation, possibly pointing to earlier stages of greater linguistic diversity than previously supposed. It is also tentatively proposed that one of the specific characteristics of the phenomena attested in the present contribution is that they tend to affect more than one language at a time, working rather as areal “phonetic possibilities” than language-bound outcomes of traditional sound change rules; in this sense, it is suggested that in-depth documentation and description can help broaden our understanding of how language contact works in highly multilingual contexts. Full article

The Tübingen Palatal Plate (TPP) is a minimally invasive yet highly effective functional orthodontic treatment for upper airway obstruction in infants with Robin Sequence (RS). It consists of a palatal plate to cover the cleft and a velar extension that shifts the root of the tongue forward. We review our practical experience with this approach. First, upon admission, our local orthodontists perform an (3-D) intraoral scan of the maxilla. Based on the scan data, the TPP is manufactured in a semi-digital workflow. The length and angulation of its extension is checked via awake laryngoscopy and the effectiveness confirmed by a sleep study. Plates are kept in place by adhesive cream. When inserting the TPP, the tip of the tongue must be visible. Next, metal fixation bows should be secured to the forehead using tape and elastic bands. Plates are removed daily for cleaning, and the oral mucosa is then checked for pressure marks. Feeding training (initially only via finger feeding) may even start before plate insertion. Breathing often normalizes immediately once the plate is inserted. For isolated RS, we have never had to perform a tracheostomy. This has largely been possible through our highly dedicated and competent team, particularly the nursing staff, and the early involvement of parents. Full article

The 22q11.2 deletion syndrome is a multisystemic disorder characterized by a marked variability of phenotypic features, making the diagnosis challenging for clinicians. The wide spectrum of clinical manifestations includes congenital heart defects—most frequently conotruncal cardiac anomalies—thymic hypoplasia and predominating cellular immune deficiency, laryngeal developmental defects, midline anomalies with cleft palate and velar insufficiency, structural airway defects, facial dysmorphism, parathyroid and thyroid gland hormonal dysfunctions, speech delay, developmental delay, and neurocognitive and psychiatric disorders. Significant progress has been made in understanding the complex molecular genetic etiology of 22q11.2 deletion syndrome underpinning the heterogeneity of clinical manifestations. The deletion is caused by chromosomal rearrangements in meiosis and is mediated by non-allelic homologous recombination events between low copy repeats or segmental duplications in the 22q11.2 region. A range of genetic modifiers and environmental factors, as well as the impact of hemizygosity on the remaining allele, contribute to the intricate genotype-phenotype relationships. This comprehensive review has been aimed at highlighting the molecular genetic background of 22q11.2 deletion syndrome in correlation with a clinical multidisciplinary approach. Full article

Hypoglossal-nerve stimulation (HGNS) is an established second-line therapy for patients with obstructive sleep apnea (OSA). Existing studies investigating the effect of preoperative drug-induced sleep endoscopic (DISE) findings on HGNS outcomes have mainly focused on the apnea/hypopnea index (AHI) among polysomnography (PSG) parameters, and have less frequently tested other PSG parameters such as the apnea index (AI), hypopnea index (HI), oxygen desaturation index (ODI), snoring index, and arousal index, or patient-reported excessive daytime sleepiness. The aim of this study was to investigate the correlation between DISE findings and the above-mentioned metrics after HGNS therapy. We only included patients with DISE findings providing detailed information about the degree of the anteroposterior velar (APV), oropharyngeal lateral wall (OPLW), or tongue-base (BT) obstruction based on the velum, oropharynx, base of tongue, and epiglottis (VOTE) classification. The data of 25 patients (9 female (36%)) were retrospectively evaluated. The mean age at the date of implantation was 54.52 ± 9.61 years, and the mean BMI was 29.99 ± 3.97 kg/m². Spearman’s rho correlation coefficients were calculated. Significant correlations were found between the degree of APV obstruction and postoperative HI (r = −0.5, p < 0.05), and between the degree of OPLW obstruction and postoperative snoring index (r = 0.42, p < 0.05). BT obstruction was strongly correlated with postoperative metrics such as AHI (r = −0.57, p < 0.01), AI (r = −0.5, p < 0.05), ODI (r = −0.57, p < 0.01), ∆ AHI (r = 0.58, p < 0.01), ∆ AI (r = 0.54, p < 0.01) and ∆ ODI (r = 0.54, p < 0.01). No significant correlation was found between DISE findings and postoperative Epworth Sleepiness Scale values. These findings suggest that preoperative DISE findings, especially the degree of BT obstruction, are important for predicting an HGNS therapy outcome. Full article

This article traces the development of voiced prepalatal obstruents /$\stackrel{⌢}{\mathrm{d}\mathrm{ʒ}}$/ and /ʒ/ in Judeo-Spanish, the language spoken by the Sephardic Jews since before their expulsion from late-15th century Spain. Using Medieval Spanish as a comparative starting point, we examine diachronic innovations in the phonological status and distribution of affricate /$\stackrel{⌢}{\mathrm{d}\mathrm{ʒ}}$/ and fricative /ʒ/ in Judeo-Spanish during the diaspora, focusing in particular on the effects of lexical borrowing from Turkish and French in territories of the former Ottoman Empire. In contemporary Sephardic communities that are in contact with non-Sephardic varieties of Mainstream Spanish, some speakers occasionally replace syllable-initial /∫/, /$\stackrel{⌢}{\mathrm{d}\mathrm{ʒ}}$/, and /ʒ/ in certain Judeo-Spanish words by a voiceless velar /x/ in efforts to accommodate the pronunciation of the corresponding Mainstream Spanish cognate form. We provide a novel analysis of Judeo-Spanish voiced prepalatal obstruents, including their diachronic and synchronic variation under language contact. The analysis combines a constraint-based approach to phonological alternations, as formalized in Optimality Theory, with a usage-based representation of the mental lexicon, as proposed in Exemplar Theory, to account for speaker- and word-specific variability. A hybrid theoretical model provides a more nuanced understanding of the relationship between lexicon and grammar in Judeo-Spanish phonology than is available in previous structuralist descriptions. Full article

Previous production studies have reported differential amounts of closure voicing in plosives depending on the location of the oral constriction (anterior vs. posterior), vocalic context (high vs. low vowels), and speaker sex. Such differences have been attributed to the aerodynamic factors related to the configuration of the cavity behind the oral constriction, with certain articulations and physiological characteristics of the speaker facilitating vocal fold vibration during closure. The current study used perceptual identification tasks to examine whether similar effects of consonantal posteriority, adjacent vowel height, and speaker sex exist in the perception of voicing. The language of investigation was Russian, a prevoicing language that uses negative VOT to signal the voicing contrast in plosives. The study used both original and resynthesized tokens for speaker sex, which allowed it to focus on the role of differences in VOT specifically. Results indicated that listeners’ judgments were significantly affected by consonantal place of articulation, with listeners accepting less voicing in velar plosives. Speaker sex showed only a marginally significant difference in the expected direction, and vowel height had no effect on perceptual responses. These findings suggest that certain phonetic factors can affect both the initial production and subsequent perception of closure voicing. Full article

This paper offers cross-experimental verification of a previous study that found that English speakers considered velars, palatals, glides, and high vowels to be sound-symbolic of light and jerky movements. Heavy and smooth movements, by contrast, were associated with affricates, glottals, laterals, and non-high vowels. The present study sought to evaluate these findings through a novel experiment with English speaking subjects, who were asked to choose appropriate sound-symbolically constructed nonce verbs for sentences describing light, heavy, smooth, or jerky manners of motion. Our results support many of Saji et al.’s findings and also offer original insights. We find complex interactions between a sound’s potential for sound-symbolic effects, and its position in initial or second syllables of disyllabic nonce words. Full article

This overview article examines vowel-consonant harmony, specifically emphatic harmony (also referred to as pharyngealization, velarization, or uvularization), which is found in Semitic languages. It provides a comprehensive overview of emphasis harmony in Arabic dialects from feature-geometric and optimality-theoretic perspectives. From the feature geometric account, emphatic consonants are considered as a natural class within the guttural group that has the [pharyngeal] or [RTR] ‘retracted tongue root’ feature. This view has been questioned and challenged recently by some researchers who argue for the exclusion of emphatics from the guttural group. The different arguments discussed in this paper show that researchers cannot reach a consensus regarding which consonants belong to the guttural group and which features are shared between these consonants. This paper shows that studies adopting an optimality-theoretic perspective provide a more comprehensive view of emphasis harmony and its fundamental aspects, namely, directional spreading and blocking, spread from secondary emphatic /r/ and labialization. However, this paper reaches two main conclusions. Firstly, unlike feature geometry, optimality theory can provide a clearer picture of emphasis harmony in an accurate and detailed way, which does not only clarify the process in one Arabic dialect but also describe the differences between dialects due to the merit of (re)ranking of constraints. Secondly, emphasis harmony is different from one Arabic dialect to another regarding its direction, involvement of emphatic /r/, and labialization. These differences between dialects indicate that emphasis harmony is not an absolute phenomenon. Full article

Chronic pulmonary aspergillosis (CPA) is a fungal infection with high mortality and morbidity rates. This disease is caused by several Aspergillus species and affects patients with an underlying respiratory condition. This pilot study aims to recognize CPA among patients with different respiratory diseases. Twenty-one out of 47 patients were classified as CPA based on the examination of clinical signs and symptoms, radiological findings, mycological culture of respiratory samples and analysis of Aspergillus IgG antibodies. There was a close association between high levels of Aspergillus IgG antibodies and the presence of cavities. Although Aspergillus flavus was the predominant species among clinical isolates, the number of isolates was small to reach conclusions on the prevalence of this species as main cause of CPA in Cuba. From the eleven evaluable patients for the treatment with itraconazole (Lozartil^®), nine improved their health status while two did not show any recovery. This drug is included in the therapy schemes for aspergillosis in Cuba. Full article