Evaluation of velopharyngeal closure by CT scan and endoscopy

Computerized tomography (CT) and endoscopy were used for the objective evaluation of velopharyngeal closure. In 19 patients with cleft palates and 9 normal subjects, CT scans of the velopharynx were made both at rest and during vowel phonation with a scanning time of 3.0 seconds and slicing width of 3 mm. At the same time, endoscopic observations of the velopharynx through the nose were carried out both at rest and during phonation. CT scan during phonation clearly demonstrated the mobility of the velopharynx, i.e., elevation of the soft palate, inward movement of the lateral pharyngeal walls, and protrusion of the posterior pharyngeal wall, in a single picture. Its disadvantage is exposure to x-rays and a rather complicated procedure. However, endoscopy is simple with no exposure to x-rays, but its disadvantage is occasional incomplete visualization because of the dead angle created by the elevated soft palate. Thus the combined use of CT and endoscopy can help to determine a rational choice of treatment for cleft palates.