Visual training for velopharyngeal closure in cleft palate patients; a fibrescopic procedure (preliminary report)

Velopharyngeal closure in various tasks was examined in 59 cleft palate patients with persistent velopharyngeal incompetence using nasopharyngeal fibrescopic (NPF) examination. The degree of velopharyngeal closure was analyzed according to the categories reported previously by Yamaoka (1973) and Matsuya et al. (1979). The NPF self-training system was developed and applied to those patients so as to investigate a longitudinal effect of the NPF in velopharyngeal closure mechanism. The training was performed every two weeks for nearly one year. The results indicated that the patient who showed complete velopharyngeal closure during blowing and/or several productions of speech samples could attain a much better improvement in all speech samples after one year of self-training. On the other hand, the patients who did not show complete velopharyngeal closure during all tasks, failed to improve the velopharyngeal closing mechanism. The ability to close the velopharynx during swallowing was seen in all patients examined. However, it appeared to have nothing to do with the prognosis of velopharyngeal closure. The data suggested that the NPF self-training system provided a strong neuro-muscular signal for velopharyngeal movement. Besides, it was considered that the NPF was a useful tool for activation of velopharyngeal activity by way of visual feed-back control.