Nasendoscopy: significant refinements of a direct-viewing technique of the velopharyngeal sphincter

The need for a three-dimensional record of velopharyngeal sphincter function in patients with craniofacial anomalies and speech problems is discussed. A refined split-screen video technique using color nasendoscope image, lateral video-fluoroscopy, and synchronous speech recording with the patient awake and in supine position is described. A special signal processor is used to position the color nasendoscopy image. The examination is recorded on 1-in. videotape. The technique allows three-dimensional appraisal of sphincter function with direct viewing and enables assessment of a range of abnormalities, assessment of the effectiveness of pharyngoplasties, and prediction of speech deformities and their management following midface craniofacial surgery.