Effective Velopharyngeal Ratio: A More Clinically Relevant Measure of Velopharyngeal Function (original) (raw)
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Changes in velopharyngeal valving with age
International journal of pediatric otorhinolaryngology, 1986
Variability of velopharyngeal valving between subjects has been a well established fact since the advent of new techniques for the direct viewing of the velopharyngeal sphincter during speech. Multi-view videofluoroscopy and nasopharyngoscopy have shown that there is variable contribution to velopharyngeal closure from the velum, the lateral pharyngeal walls, and posterior pharyngeal wall from person to person. However, to date, there has been no evidence to show if velopharyngeal closure remains unchanged within individuals throughout life. The purpose of this investigation was to observe velopharyngeal closure in normal subjects and subjects with cleft palate from prepubertal to postpubertal life (i.e. pre-adenoid involution to post-adenoid involution). Changes in velopharyngeal closure patterns were observed in 60% of the normals studied and 30% of the cleft subjects.
Journal of Craniofacial Surgery, 2016
The purpose of this study was to create a 3D volumetric segmentation from magnetic resonance imaging (MRI) of the nasopharyngeal space and adenoid tissue and to examine the relationship between nasopharyngeal volume (NPV), adenoid volume, and linear measures of the velopharyngeal structures, pharynx, and vocal tract in children with and without cleft palate. A total of 24 participants including 18 typically developing children (4-8 years of age) and 6 children (4-8 years of age) with varying degrees of cleft palate were imaged using MRI. Linear and volumetric variables varied significantly based on age. Overall, NPV demonstrates a modest increase with age. Nasopharyngeal volume was positively correlated with age (P ¼ 0.000), oronasopharyngeal volume (P ¼ 0.000), velar length (P ¼ 0.018), and velar thickness (P ¼ 0.046). These variables tend to increase together. Differences in NPV between groups (bilateral cleft lip and palate, submucous cleft lip and palate, unilateral cleft lip and palate [UCLP], and noncleft) were statistically significant (P ¼ 0.007). Participants with bilateral cleft lip and palate demonstrated greater NPVs than those with UCLP and submucous cleft palate.
European Journal of Plastic Surgery, 1998
The disadvantages and limitations of imaging methods to investigate velopharyngeal incompetence have created some difficulties in the management of this condition. Seven normal volunteers and seven patients who were suffering from a speech disorder were examined using magnetic resonance imaging. The velopharyngeal aperture was evaluated at rest and during phonation. In normal volunteers, the velopharyngeal aperture area had a mean value of 1.632 cm 2 while at rest and complete closure was obtained during the phonation of /s/ sound. Detailed information was obtained about the function of the levator palati muscle. In five patients during the phonation of /s/ sound there was an increase in the area of the velopharyngeal aperture when compared to the volunteers. Investigation with magnetic resonance imaging is helpful in the pretreatment evaluation and postopertive follow-up examination of velopharyngeal insufficiency. As a result, this noninvasive method can be used as an alternative to conventional radiological investigations.
Objective, Noninvasive Evaluation of Velopharyngeal Function in Cleft and Noncleft Patients
The Cleft Palate-Craniofacial Journal, 1998
The purpose of this study was to investigate a new diagnostic method that provides an approach to noninvasive, objective measurement of velopharyngeal movement by acoustic determination of epipharyngeal volume changes with velopharyngeal muscle function. Design: This was a case control study, using consecutive samples. Setting: This study took place at the Cleft Palate Rehabilitation Center of the University of Mainz, Germany. Patients: Subjects were 29 consecutive cleft lip and palate (CLP) patients and 31 controls (21 patients with dysgnathia and 10 healthy volunteers). Intervention: A series of transnasal acoustic measurements (pressure wave: 55 dB for 2 milliseconds) of epipharyngeal volume were performed with the pharyngeal muscles relaxed in end-expiration and while the velopharyngeal orifice was closed, with the difference in volume representing maximal pharyngeal movement. Results: Cleft palate patients yielded significantly lower values of velopharyngeal movement (6.5 cm 3) than did the control group (8.0 cm 3) (p Ͻ .05; Mann-Whitney U test). Overlapping ranges of values were measured for the C(L)P and control groups. The least mobility (4.75 cm 3) was measured in patients who had undergone pharyngeal flap surgery. Different patterns of restriction were observed in patients with and without a pharyngeal flap. Conclusion: Acoustic pharyngometry may provide access to noninvasive quantitative measurement of velopharyngeal movement and a better understanding of the pattern of movement in C(L)P-patients. We expect it to be a helpful tool in objectively monitoring the progress of logopedic therapy.
International Archives of Otorhinolaryngology, 2014
Introduction: Velopharyngeal dysfunction may cause impaired verbal communication skills in individuals with cleft lip and palate; thus, patients with this disorder need to undergo both instrumental and auditory-perceptual assessments. Objective: To investigate the main methods used to evaluate velopharyngeal function in individuals with cleft lip and palate and to determine whether there is an association between videonasoendoscopy results and auditory-perceptual assessments. Method: We conducted a systematic review of the literature on instrumental and auditory-perceptual assessments. We searched the PubMed, Medline, Lilacs, Cochrane, and SciELO databases from October to November 2012. Summary of findings: We found 1,300 studies about the topic of interest published between 1990 and 2012. Of these, 56 studies focused on velopharyngeal physiology; 29 studies presented data on velopharyngeal physiology using at least 1 instrumental assessment and/or 1 auditory-perceptual assessment, and 12 studies associated the results of both types of assessments. Only 3 studies described in detail the analysis of both methods of evaluating velopharyngeal function; however, associations between these findings were not analyzed. Conclusion: We found few studies clearly addressing the criteria chosen to investigate velopharyngeal dysfunction and associations between videonasoendoscopy results and auditory-perceptual assessments.
The Cleft Palate-Craniofacial Journal, 2017
Objective:The purpose of this study was to quantify the growth of the various craniofacial and velopharyngeal structures and examine sex and race effects.Methods:Eight-five healthy children (53 white and 32 black) with normal velopharyngeal anatomy between 4 and 9 years of age who met the inclusion criteria and successfully completed the magnetic resonance imaging (MRI) scans were included in the study.Results:Developmental normative mean values for selected craniofacial and velopharyngeal variables by race and sex are reported. Facial skeleton variables (face height, nasion to sella, sella to basion, palate height, palate width) and velopharyngeal variables (levator muscle length, angle of origin, sagittal angle, velar length, velar thickness, velar knee to posterior pharyngeal wall, and posterior nasal spine to levator muscle) demonstrated a trend toward a decrease in angle measures and increase in linear measures as age increased (with the exception of posterior nasal spine to le...