Velopharyngeal function in association with artificial obstruction of the nose: a videonasendoscopic study

Artificial obstruction of the nose can make the nasal cavity a cul-de-sac resonator, which has clearly audible consequences. The present study compares videonasendoscopic views of the velopharyngeal mechanism in test words uttered with the nose open and obstructed in 20 subjects with a Pierre Robin sequence and in 6 subjects without this sequence. A velopharyngeal flap was constructed on 12 subjects. Videonasendoscopic findings were assessed by 3 judges with acceptable agreement. The results indicated that impairment of velopharyngeal function occurred significantly more often in subjects with a velopharyngeal flap. This was attributed to aerodynamic reasons. Clinical implications of the results are discussed.