Diagnosis and treatment of velopharyngeal insufficiency - Clinical utility of speech evaluation and videofluoroscopy

被引:53
作者
Dudas, JR
Deleyiannis, FWB
Ford, MD
Jiang, S
Losee, JE
机构
[1] Childrens Hosp Pittsburgh, Div Pediat Plast Surg, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, Div Plast Surg, Pittsburgh, PA USA
关键词
speech pathology; velopharyngeal insufficiency; videofluoroscopy; perceptual speech symptoms; cleft palate;
D O I
10.1097/01.sap.0000210628.18395.de
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: The workup of velopharyngeal insufficiency (VPI) includes speech pathology evaluation and examination of velopharyngeal anatomy and physiology. This study sought to determine whether perceptual speech symptoms were predictive of velopharyngeal closure. Patients and Methods: A retrospective chart review of patients with VPI following primary palatoplasty was performed. All patients underwent perceptual speech evaluation using the Pittsburgh Weighted Speech Scale (PWSS) and examination of velopharyngeal anatomy by videofluoroscopy. PWSS scores were correlated to velopharyngeal closure. Results: All patients exhibited clinical VPI (PWSS = 5-27). No patient demonstrated complete velopharyngeal-closure on videofluoroscopy. Velopharyngeal closure on the lateral view showed a statistically significant, moderate correlation with both the PWSS total score (rs = -0.424; P = 0.03) and the phonation subscore (rs = -0.405; P = 0.04). Conclusions: Although certain aspects of speech are related to velopharyngeal anatomy, speech and videofluoroscopic studies each provide unique information in the workup of VPI. Selection of surgical approach often depends on anatomic factors, and improvement in speech postoperatively indicates successful treatment.
引用
收藏
页码:511 / 517
页数:7
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