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The evaluation of velopharyngeal function using flexible nasendoscopy

Published online by Cambridge University Press:  29 June 2007

L. Ramamurthy ,
R. A. Wyatt ,
D. Whitby ,
D. Martin  and
P. Davenport
L. Ramamurthy*
Affiliation:
Department of Otolaryngology, South Manchester University Hospital NHS Trust, Withington Hospital, Manchester, UK.
R. A. Wyatt
Affiliation:
Department of Speech and Language Therapy, South Manchester University Hospital NHS Trust, Withington Hospital, Manchester, UK.
D. Whitby
Affiliation:
Department of Plastic Surgery, South Manchester University Hospital NHS Trust, Withington Hospital, Manchester, UK.
D. Martin
Affiliation:
Department of Radiology, South Manchester University Hospital NHS Trust, Withington Hospital, Manchester, UK.
P. Davenport
Affiliation:
Department of Plastic Surgery, South Manchester University Hospital NHS Trust, Withington Hospital, Manchester, UK.
*
Address for correspondence: Miss L. Ramamurthy, F.R.C.S., 60 Ashtead Road, Brooklands, Sale, Chesire M33 3PX.
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Abstract

Nasendoscopy is an essential tool in assessing the dynamic function and structure of the velopharyngeal sphincter during speech and swallowing.

Flexible fibre-optic nasendoscopy has been used by the cleft palate team at Withington Hospital, Manchester since 1989. Seventy-six patients were referred between 1989 and 1994 for evaluation of velopharyngeal function during speech. Flexible nasendoscopic evaluation was attempted in 50 patients, and successfully carried out in 43 patients. The age range was four years to 77 years (mean 21 years). The patients were divided into two groups: Group 1 consisting of patients with cleft palate and Group 2 comprised of patients with non-overt cleft palate-related velopharyngeal dysfunction of various aetiologies; such as, submucous cleft, post-tonsillectomy, post-adenoidectomy, neurological and post-traumatic.

Based on the findings on nasendoscopy, videofluoroscopy and clinical speech/voice analysis the following treatment options were recommended: 17 (40 per cent) for pharyngoplasty, five (11 per cent) for revision pharyngoplasty, 15 (35 per cent) for speech therapy, four for an obturator and one for tonsillectomy. Two previously undetected submucous clefts were diagnosed.

Keywords

EndoscopyNasopharynx
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 8 , August 1997 , pp. 739 - 745
Copyright
Copyright © JLO (1984) Limited 1997

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References

Croft, C. B., Shprintzen, R. J., Danillier, A. I., Lewis, M. L. (1978) The occult submucous cleft palate and the musculus uvulae. Cleft Palate Journal 15: 150–154.Google Scholar
Croft, C. B., Shprintzen, R. J., Rankoff, S. J. (1981) Patterns of velopharyngeal valving in normal and cleft palate subjects: a multi-view videofluoroscopic and nasoendoscopic study. Laryngoscope 91: 265–271.CrossRefGoogle Scholar
D'Antonio, L. L., Lotz, W., Chait, D., Netzell, R. (1986) Paediatric videonasendoscopy for speech and voice evaluation. Otolaryngology-Head and Neck Surgery 94: 578–583.Google Scholar
D'Antonio, L. L., Muntz, H. R., Marsh, J. L., Grames, L. M., Backensto-Marsh, R. (1988) Practical application of flexible fibreoptic nasopharyngoscopy for evaluating velopharyngeal function. Plastic and Reconstructive Surgery 82: 611–618.Google Scholar
D'Antonio, L. L., Marsh, J. L., Province, M. A., Muntz, H. R., Phillips, C. J. (1989) Reliability of flexible fiberoptic nasopharyngoscopy for the evaluation of velopharyngeal function in a clinical population. Cleft Palate Journal 26: 217–225.Google Scholar
Kaplan, E. N. (1975) The occult submucous cleft palate. Cleft Palate Journal 12: 356.Google Scholar
Muntz, H. R. (1987) The use of two instrumental techniques in the evaluation of speech disorders in children. Insights 2: 1–5.Google Scholar
Muntz, H. R. (1992) Navigation of the nose with flexible fibreoptic endoscopy. Cleft Palate – Craniofacial Journal 29: 507–510.CrossRefGoogle Scholar
Pigott, R. W. (1969) The nasendoscopic appearance of the normal palatopharyngeal valve. Plastic and Reconstructive Surgery 43: 19–24.CrossRefGoogle ScholarPubMed
Sawashima, M., Hirose, H. (1968) New laryngoscopic technique by use of fibreoptics. Journal of the Acoustical Society of America 43: 168–169.Google Scholar
Shprintzen, R. J. (1989) Nasopharyngoscopy. Communicative Disorders Related to Cleft Lip and Palate, Third Edition. A College-Hill Publication, London, pp 211–229.Google Scholar
Shprintzen, R. J., Lewin, M. L., Rakoff, S. J., Sidoti, E. J., Croft, C. (1976) Diagnosis of small central gaps in the velopharyngeal sphincter. Cleft Palate Journal 13: 415.Google Scholar
Shprintzen, R. J., Lencione, R. M., McCall, G. N., Skolnick, M. L. (1974) A three-dimensional cinefluoroscopic analysis of velopharyngeal closure during speech and non-speech activities in normals. Cleft Palate Journal 11: 412–428.Google Scholar
Witzel, M. A., Tobe, J., Salyer, K. (1988) The use of nasopharyngoscopy biofeedback therapy in the correction of inconsistent velopharyngeal closure. International Journal of Pediatric Otorhinolaryngology 15: 137–142.Google Scholar