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Velopharyngeal incompetence in patients with cleft palate, flexible video pharyngoscopy and perceptual speech assessment: a correlational pilot study

Published online by Cambridge University Press:  22 October 2014

S Rajan
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu, India
M Kurien
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu, India
A K Gupta
Affiliation:
Department of Plastic Surgery, Christian Medical College, Vellore, Tamil Nadu, India
S S Mathews
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu, India
R R Albert
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu, India
D Tychicus
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu, India
Corresponding
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Abstract

Objectives:

To assess the role of video endoscopy in evaluating velopharyngeal incompetence and investigate a possible relationship between velopharyngeal incompetence type and speech defect in cleft palate patients.

Methods:

A prospective study of 28 pre- or post-operative cleft palate patients with speech defects who attended Plastic Surgery–Cleft Palate and ENT out-patient clinics was performed. The velar defect type was determined using a flexible endoscope and findings were video recorded. Speech pathology was assessed using the cleft palate audit protocol for speech.

Results:

A significant, clinically relevant relationship was noted between the perceived characteristics of hypernasality and velopharyngeal insufficiency type. Hypernasal speech was a definite clinical indicator of velopharyngeal incompetence, and the type 1 velopharyngeal defect was most common. Type 1 velopharyngeal coronal-type dysfunction was strongly associated with hypernasality (p < 0.05). When speech substitution was noted, type 2 velopharyngeal (or sagittal) incompetence could be predicted (p < 0.05).

Conclusion:

In the management of cleft palate patients, it is important that surgical correction of the defect and achieving velopharyngeal competency for speech are performed simultaneously. Pre-operative velopharyngeal endoscopy with speech assessment will define the anatomical and functional bases for velopharyngeal correction and assist in planning and tailoring the pharyngeal flap.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2014 

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References

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Velopharyngeal incompetence in patients with cleft palate, flexible video pharyngoscopy and perceptual speech assessment: a correlational pilot study
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