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Objective evaluation of velopharyngeal function by acoustic reflection measurements
M Kunkel1, U Wahlmann, W Wagner
1Klinik für Mund-, Kiefer- und Gesichtschirurgie (Direktor: Univ.-Professor Dr. Dr. W. Wagner), Johannes Gutenberg-Universität Mainz, Mainz, Deutschland.
Objective:
To investigate whether acoustic pharyngometry is capable of discriminating velopharyngeal mobility in cleft and non-cleft subjects by determination of epipharyngeal volume changes with active muscle function.
Design:
Case control study, consecutive sample.
Setting:
Cleft palate rehabilitation centre.
Patients:
Thirty-three consecutive cleft palate patients, among them 10 following pharyngeal flap surgery and 32 controls without velopharyngeal pathology.
Intervention:
Transnasal acoustic measurements of airway cross-sectional area in the state of relaxed and tensed pharyngeal muscles. Determination of epipharyngeal volume changes by integrating the difference of the airway profile from the choane for a distance of 5 cm (EV 0-5 ). Measurements of defined changes in the epipharynx served as reference.
Results:
Acoustic pharyngometry is capable of discriminating (P < 0.05; U test, Mann-Whitney) the volume effect of velopharyngeal mobility in CP patients (6.5 cm (3) ) from the control group (8.0 cm (3) ). A 'pharyngeal flap type' and a 'non-pharyngeal flap type' of restriction was observed. The individual effect of velopharyngoplasty on pharyngeal mobility can thus be determined.
Conclusion:
Acoustic pharyngometry is a non-invasive, quantitative investigation technique which seems well suited for the evaluation of velopharyngeal mobility. We expect it to be a helpful tool in objectively monitoring the effect of therapeutic intervention on velopharyngeal mobility, and it may provide a better understanding of the pattern of movement in CP patients.
