Variations in Velopharyngeal Closure Assessed by Endoscopy

Abstract

Velopharyngeal closure may be observed directly with a laryngeal telescope 6 mm in diameter. The speech sample used during the endoscopic examination should include several repetitions of a plosive consonant to insure sustained closure. Thirty-four normal subjects were observed, and the percentage of occurrence in four categories of velar and lateral wall approximation was calculated and categorized. To confirm the observations, cineradiographic (lateral and submentovertical projections) and telescopic observations were compared. Parallel observations were made for both methods. The procedure for using the telescope is explained, and issues relating to interpretation of telescopic observations are discussed.

Utilization of Transoral Endoscopy to Assess Velopharyngeal Closure

“…Over a several year period the author first categorized lateral wall movement among normal patients (Zwitman, 1974); then in patients with velar insufficiency (Zwitman, 1976). In the second study the findings revealed that during phonation the absence of lateral wall motion (Category 1) was observed more often in subjects with velar insufficiency and that lateral wall motion past the sides the velum (Categories 3 and 4) occurred less frequently.…”

Noninstrumental Assessment of Velopharyngeal Adequacy in Children

“…Radiology (Shprintzen et al, 1974) 2. Endoscopy (Pigott, Benson, and White, 1969;Taub, 1966;Willes and Stutz, 1972;Zwitman, Sonderman, and Ward, 1974) 3. Electromyography (Fritzell, 1969(Fritzell, , 1979 4.…”

Treatment of velopharyngeal closure for speech: Discussion and implications for management.

“…The velum moves in an upward and backward direction to articulate with the pharyngeal walls. Normal speakers exhibit differential patterns of muscle activity of the velum, lateral pharyngeal walls and posterior pharyngeal wall (Iglesias, Kuehn, & Morris, 1980; Shprintzen, Lencione, McCall & Skolnick, 1974; Zwitman, Sonderman, & Ward, 1974). That is, they achieve closure but the articulators contribute in different ways depending on the speaker.…”