Nasoendoscopy of velopharynx before and during diagnostic therapy

Area of Science:

• Speech-language pathology
• Otolaryngology
• Pediatric medicine

Background:

• Nasoendoscopy is crucial for evaluating velopharyngeal function.
• Assessing velopharyngeal function in children with cleft lip and palate is complex.
• Standard nasoendoscopic evaluations may not fully elicit velopharyngeal movement.

Purpose of the Study:

• To analyze velar and pharyngeal wall movement during nasoendoscopy.
• To evaluate velopharyngeal gap changes before and during diagnostic therapy.
• To determine the impact of diagnostic therapy on velopharyngeal function in children with cleft lip and palate.

Main Methods:

• Nasoendoscopic recordings of 10 children with operated cleft lip and palate were analyzed.
• Evaluations were conducted before and during diagnostic therapy involving intraoral air pressure.
• Three speech-language pathologists rated velar/pharyngeal wall movement and velopharyngeal gap characteristics.

Main Results:

• Velar and pharyngeal wall displacement increased significantly during diagnostic therapy (velum 40%, posterior pharyngeal wall 10%, right/left lateral pharyngeal walls 70-80%).
• Statistical significance was found for lateral pharyngeal wall displacement.
• Velopharyngeal gap size reduced in 30% of patients, and gaps closed in 40%, with statistically significant changes observed.

Conclusions:

• Diagnostic therapy strategies enhance the elicitation of maximal velopharyngeal displacement during nasoendoscopy.
• Incorporating diagnostic therapy provides more comprehensive information for managing velopharyngeal dysfunction.
• Speech-language pathologist involvement is essential for optimizing nasoendoscopic assessments and patient management.