Image processing of videofluoroscopy of patients with velopharyngeal insufficiency and hypernasal speech

Eleven patients with hypernasal speech and velopharyngeal insufficiency (VPI), together with five normals, were evaluated by videofluoroscopy to assess velopharyngeal movement, velar lift and lateral pharyngeal wall movement. Computer processing of the images obtained was used to compensate for initial poor quality images by contrast and edge enhancement techniques and to provide objective measurement of the movements involved. It was demonstrated that objective computer aided analysis of videofluoroscopic images is feasible and may provide additional subtle diagnostic information when nasendoscopy is unavailable. In addition, results obtained showed an increased degree of velar lift and lateral pharyngeal wall movement for the more severely affected patients. These suggest a compensatory mechanism in operation for the more severe cases of VPI.