Video Velopharyngography in Patients with Nasal Speech, with Emphasis on Lateral Pharyngeal Motion in Velopharyngeal Closure

Ml, Skolnick

doi:10.1148/93.4.747

Cited by 69 publications

(21 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The AP view, however, is useful in evaluation of the lateral pharyngeal walls and uvular deviation. With the head in extension in the AP view, the soft palate is projected above the hard palate (Skolnick 1969). A basal view of the velopharyngeal portal also aids in evaluating the lateral aspect of the nasopharynx, the uvula, and the palatopharyngeal folds.…”

mentioning

confidence: 99%

Radiology of the adult soft palate

1987

View full text Add to dashboard Cite

Abstract. Radiographic examination of the adult soft palate has been largely ignored, perhaps because the soft palate is easily inspected on its inferior surface and visualized on its superior surface with a flexible nasopharyngoscope. The major radiologic effort to date has been in the evaluation of cleft palate. A variety of adult neurologic, inflammatory, and neoplastic disorders of the soft palate, however, can benefit from radiologic examination. This article describes useful radiologic techniques, reviews the anatomy of the soft palate, and presents illustrative pathologic states.

show abstract

mentioning

confidence: 99%

Radiology of the adult soft palate

1987

View full text Add to dashboard Cite

show abstract

“…4, No . 1, 198 : preferred methods and permits accurate assessment of the anatomy and physiology of the soft palate and lateral and posterior walls of the velopharynx [6,[19][20][21][22]29] .…”

Section: Discussionmentioning

confidence: 99%

Velopharyngeal insufficiency in tetralogy of Fallot: A report of four cases

et al. 1983

View full text Add to dashboard Cite

SUMMARY . This report describes 4 children with tetralogy of Fallot and velopharyngeal insufficiency, but not cleft palate . Since there may be an association between velopharyngeal insufficiency and tetralogy of Fallot, careful attention should be paid to the speech of children with tetralogy . KEY WORDS : Velopharyngeal insufficiency -Tetralogy of Fallot -Speech disordersNormal nasal resonance and the proper production of most speech sounds require adequate velopharyngeal closure . Such closure is achieved by a coordinated muscle system which functions as a sphincter with both velar and pharyngeal components [23,24] . The velum (soft palate) lifts and moves posteriorly whereas the pharyngeal walls may move medially and/or anteriorly . When there is inadequate closure (velopharyngeal insufficiency), excess air enters the nasal cavity and affects articulation and the resonance of voice (hypernasality) . This condition is most frequently associated with cleft or submucous cleft palate ; it can also occur with a foreshortened palate, a capacious pharynx, or a neuromuscular deficiency of the soft palate and/or pharyngeal musculature . In patients whose adenoidal tissue thickens the posterior pharyngeal wall, thus aiding in velopharyngeal closure, removal of the adenoids may unmask velopharyngeal insufficiency [8, 271 . Velopharyngeal insufficiency has also been reported in children who have tetralogy of Fallot or other types of congenital heart disease [7, 251 . This report describes 4 patients with velopharyngeal insufficiency but no obvious cleft palate in whom tetralogy of Fallot had been diagnosed . A 4 .5-year-old boy was referred for assessment of velopharyngeal insufficiency in 1975 . Neonatal anoxic spells led to a diagnosis of tetralogy of Fallot with pulmonary atresia and a right aortic arch . A left Blalock-Taussig shunt had been performed at age I year and at 2 .5 years, a Waterston shunt because of persistent severe cyanosis . A tonsillectomy and adenoidectomy was performed at age 4 years because of frequent respiratory infections . Postoperatively, velopharyngeal insufficiency became apparent .The patient's early speech development had been delayed . At assessment, his speech was characterized by moderate hypernasal resonance . Although articulation was commensurate with the child's age, he had difficulty producing the sibilant sounds (sun, zoo, chair, shoe) .On videofluoroscopic examination during speech, velopharyngeal closure was not obtained . The anterior-posterior dimension of the pharynx was increased [26] and neuromuscular weakness of the soft palate was suspected .Treatment of the velopharyngeal insufficiency-pharyngealflap surgery [51 at age 5 .3 years, and speech therapy-improved vocal resonance and articulation significantly . However, 2 years later, his exercise tolerance decreased and he died after pulmonary arterioplasty and right-ventricular-outflow reconstruction . Articulation was defective, and there was hypernasal resonance and flaring of the nares during speech . The child had l...

show abstract

“…In 1969 two new procedures for direct visualization of the velopharyngeal valve were introduced; the multi-view video fluoroscopy (Skolnick) (7,8,9) and nasopharyngoscopy by (Pigott). (10,11) this revised the scientific community's concept of velopharyngeal closure.…”

Section: Review Of Literaturementioning

confidence: 99%

Double Blind Comparative Study of Sommerlad’s Levator Myoplasty and Furlow’s Double Opposing Z Plasty

T¹,

D²,

Srikanth³

et al. 2015

jemds

View full text Add to dashboard Cite

AIMS AND OBJECTIVES:Aim of this study is to make out efficiency of these surgical techniques in correction of Velopharyngeal incompetence (V.P.I). MATERIALS AND METHODS: 20 cases of Velopharyngeal incompetence initially screened by speech therapist followed by accessing velopharyngeal gap and documenting in patients between 5to 15 years age group of both the sexes. They were randomly allotted for Furlow's double opposing Z plasty and Sommerlads's levator myoplasty. All these procedures were done by the same surgeon to avoid surgeon bias. Two to three years after surgery all these patients were subjected for Videofluroscopy. Velopharyngeal gaps were recorded and documented. Preoperative and post-operative Velopharyngeal gaps were recorded and analysed. RESULTS AND CONCLUSION: Both these techniques were equally efficacious in correction of Velopharyngeal incompetence if Velopharyngeal gap is less than 5mm. However both these techniques were failed to close if Velopharyngeal gap is more than 5mm.In such cases posterior wall augmentation was needed to obtain Velopharyngeal closure. KEYWORDS: Velopharyngeal incompetence, palatal lengthening procedures, posterior pharyngeal wall augmentation, microscopic levator myoplasty, Furlow's double opposing Z plasty. INTRODUCTION:The primary goal of cleft palate repair with or without cleft lip is to attain good speech function. Surgery of cleft palate came a long way from mere anatomical closure of cleft to a more functional closure of velopharynx with a stress on muscle repair and reorientation of muscle fibers, all aimed at obtaining normal or near normal speech. Current concepts of cleft palate repair states that a child with cleft palate should ideally be operated around the age of 9 months to 1 year, based on the age at which the normal speech purportedly develops.Even in the best hands, 5-38% of the patients develop velopharyngeal incompetence following primary palatal surgery, resulting in abnormal speech.Normal speech is characterized by intra oral build up and release of oral air stream for the production of various phonemes. This is mainly achieved by a valve like functioning of velum and pharynx; velum moves posteriorly and superiorly and pharynx moves medially and superiorly to close velopharyngeal gap, thus changing air flow. During normal conversational speech velopharynx moves rapidly, opening for velopharyngeal sounds and closing it for adjacent oral sounds. The ability to open and close the velopharynx rapidly so that speech has normal nasal and oral features constitutes normal velopharyngeal competence.Velopharyngeal incompetence is inability to close the velopharyngeal sphincter completely; it can occur due to any structural defect of the velum or pharyngeal wall at the level of nasopahrynx or mechanical interference for closure. A complete understanding of the velopharyngeal closure is essential for the assessment and selection of adequate and optimal methods of treating the patients with velopharygeal incompetence.

show abstract

Video Velopharyngography in Patients with Nasal Speech, with Emphasis on Lateral Pharyngeal Motion in Velopharyngeal Closure

Cited by 69 publications

References 13 publications

Radiology of the adult soft palate

Radiology of the adult soft palate

Velopharyngeal insufficiency in tetralogy of Fallot: A report of four cases

Double Blind Comparative Study of Sommerlad’s Levator Myoplasty and Furlow’s Double Opposing Z Plasty

Contact Info

Product

Resources

About