Image analysis of lateral velopharyngeal closure in repaired cleft palates and normal palates

Birch, Malcolm; Sommeriad, Brian C.; Bhatt, Aomesh

doi:10.1016/0007-1226(94)90067-1

Cited by 32 publications

(16 citation statements)

References 7 publications

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“…The lack of consistent relationship between nasalance and "closure ratio" measured on nasendoscopic images is attributable to the difficulty in always visualizing the entire velopharyngeal portal, assessing the cephalocaudal position of maximum closure during quantitative measurement, and issues with lens or barrel distortion (Lam et al, 2006;Gilleard, 2008;Sell and Pereira, 2011). Significant relationships were found for "closure ratio" between measurements made on nasendoscopic images and those made on videofluoroscopic images using the methodology based on Birch et al (1994;, at both presurgery and post-surgery time points, suggesting clinical and research validity and utility of the measurement method.…”

Section: Discussionmentioning

confidence: 99%

“…An external hypercardioid condenser microphone (Rode NT 3) was used for all recordings. A head-alignment device with a calibration ring attached (Sommerlad et al 1994) was used during the procedure to reduce unwanted head movement and to facilitate ratiometric measurements. The ring, located in the same midsagittal plane as the participant's head, was always screened at the same magnification in order to make quantitative ratiometric measurements.…”

Section: Instrumental Measuresmentioning

confidence: 99%

“…A reliable and validated measurement system that allows for absolute and relative or ratiometric measures of velar parameters based on lateral videofluoroscopic images has been described (Birch et al, 1994;Birch et al, 1999). This methodology involves the use of a computer software, Image-Pro (Media Cybernetics) which allows for the manual measurement of point-to-point 2-dimension and 3-dimension line distances as well as angles, thus allowing for velar parameters such as closure ratio and velar extensibility to be measured reliably.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Maxillary Osteotomy on Speech in Cleft Lip and Palate: Instrumental Outcomes of Velopharyngeal Function

Pereira

Tuomainen

Hay

et al. 2020

The Cleft Palate Craniofacial Journal

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Objective: To investigate the effect of maxillary osteotomy on velopharyngeal function in cleft lip and palate (CLP) using instrumental measures. Design: A prospective study. Participants: A consecutive series of 20 patients with CLP undergoing maxillary osteotomy by a single surgeon were seen at 0 to 3 months presurgery (T1), 3 months (T2), and 12 months (T3) post-surgery. Interventions: Nasalance was measured on the Nasometer II 6400. For videofluoroscopy and nasendoscopy data, visual perceptual ratings, for example, palatal lift angle (PLAn), and quantitative ratiometric measurements, for example, closure ratio (CRa), were made using a validated methodology and computer software. Reliability studies were undertaken for all instrumental measures. Main Outcome Measures: Repeated measures analysis of variance (with time at 3 levels) for nasalance and each velar parameter. Planned comparisons across pairs of time points (T1-T2, T1-T3, and T2-T3) including effect sizes. Results: A significant difference over time was found for nasalance ( P = .001) and planned comparisons across pairs of time points were significant between T1 and T2 ( P = .008), T1 and T3 ( P = .002), but not between T2 and T3 ( P = .459) providing evidence that maxillary osteotomy can impact on nasalance adversely and that the changes seen are permanent and stable. There were also significant differences over time for PLAn ( P = .012) and CRa ( P = −.059) and planned comparisons for both velar parameters reflected similar findings to those of nasalance. Conclusions: Maxillary osteotomy can adversely affect velopharyngeal function in patients with CLP. The study provides evidence for a much earlier post-surgery review even as early as 3 months after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Instrumental Measuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Maxillary Osteotomy on Speech in Cleft Lip and Palate: Instrumental Outcomes of Velopharyngeal Function

Pereira

Tuomainen

Hay

et al. 2020

The Cleft Palate Craniofacial Journal

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“…Linear measurements as per the guidelines proposed by an international working group 14 were adhered to for measuring the gap sizes in the videofluoroscopic images. The measurements made were resting gap, velar gap, velar excursion, and closure ratio, 14 and a technique of measurement was adapted from the measurement method described by Birch et al 15 31 Points were marked as shown in Fig. 1 .…”

Section: Methodsmentioning

confidence: 99%

Velopharyngeal Closure and Resonance in Children Following Early Cleft Palate Repair: Outcome Measurement

Aparna

Pushpavathi

Bonanthaya

2019

Indian J Plast Surg

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Introduction Timing of cleft palate repair and the method of speech outcome measurement in children with cleft lip and palate are much debated topics. The associated problems and quality of life in these children depend on the timing of the surgery. Aim The aim of this study was to investigate the velopharyngeal (VP) function and resonance parameters in children following early cleft palate repair. Method A total of 25 Kannada-speaking children with early repaired cleft palate were subjected to speech assessment and videofluoroscopic assessment. Perceptual speech parameters measured were severity of hypernasality and presence of nasal air emission. Videofluoroscopy was interpreted in terms of closure ratios to predict the severity of VP dysfunction. Results The analysis of videofluoroscopic images indicated that 48% of children had complete VP closure and 52% had perceptually normal resonance. A good correlation was found between the closure ratio and hypernasality. Conclusion Understanding the perceptual speech parameters and their structural correlates for outcome measurement will give better evidence for refining the existing treatment protocols. Data on a larger population are warranted for establishing predictors of optimum speech outcome.

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“…56 Effective velar length refers to the portion of the soft palate that contributes to velopharyngeal closure, located between the posterior edge of the hard palate and levator knee or eminence (Figure 18.11). In the authors practice, lateral view videofluoroscopy only is performed, as this view is deemed to provide the most anatomic and diagnostic information with regards to levator function, and its functional relation to the posterior pharyngeal wall.…”

Section: Assessment Of Velopharyngeal Functionmentioning

confidence: 99%

Cleft palate and velopharyngeal dysfunction

Cugno

Sommerlad

2015

Plastic and Reconstructive Surgery

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Image analysis of lateral velopharyngeal closure in repaired cleft palates and normal palates

Cited by 32 publications

References 7 publications

Effect of Maxillary Osteotomy on Speech in Cleft Lip and Palate: Instrumental Outcomes of Velopharyngeal Function

Effect of Maxillary Osteotomy on Speech in Cleft Lip and Palate: Instrumental Outcomes of Velopharyngeal Function

Velopharyngeal Closure and Resonance in Children Following Early Cleft Palate Repair: Outcome Measurement

Cleft palate and velopharyngeal dysfunction

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