Using Active-Phonation Cone-Beam Computed Tomography to Evaluate Pediatric Patients With Suspected Velopharyngeal...

Area of Science:

• Medical Imaging
• Speech Pathology
• Pediatric Otolaryngology

Background:

• Velopharyngeal dysfunction (VPD) affects speech by incomplete velopharyngeal port closure.
• Nasopharyngoscopy and videofluoroscopy are traditional diagnostic methods for VPD.
• Cone-beam computed tomography (CBCT) offers detailed anatomical visualization and precise measurements.

Purpose of the Study:

• To assess the feasibility of active-phonation CBCT for diagnosing suspected VPD in pediatric and young adult populations.
• To compare the diagnostic accuracy of active-phonation CBCT with nasopharyngoscopy.
• To evaluate patient tolerance of active-phonation CBCT versus nasopharyngoscopy.

Main Methods:

• Prospective pilot study involving 6 patients (ages 6-26) with suspected VPD.
• Subjects underwent comprehensive speech evaluation, active-phonation CBCT, and nasopharyngoscopy.
• VPD presence and severity were assessed by experienced clinicians.

Main Results:

• Both active-phonation CBCT and nasopharyngoscopy detected incomplete velopharyngeal closure in all 6 patients (100%).
• Two patients (33%) did not tolerate nasendoscopy.
• No significant difference in VPD detection or severity grading between CBCT and nasopharyngoscopy (P=0.61).

Conclusions:

• Active-phonation CBCT is a viable adjunct for accurate VPD diagnosis.
• CBCT may offer better patient tolerance compared to nasopharyngoscopy.
• Quantitative data from CBCT can aid in treatment planning and surgical optimization.