The Use of the Aerophonoscope for Assessing Velo-Pharyngeal Incompetence and Therapeutic Decisions

Abstract

Aerophonoscope is an ultra sensitive and original instrument for detecting nasal airflow and analysing the Velo-Pharyngeal Sphincter –VPS - movements. It reveals the aerodynamic function of the VPS, in the usual conditions of speaking and breathing. It has been created for patients with facial cleft, of 4 years old upwards, after primary surgery and during their growth, in a harmless, non-invasive way. There are several sorts of assessments of Velo-Pharyngeal Incompetence (VPI): from an anatomical point of view, a perceptive, acoustic, aerodynamic one. The Aerophonoscope belongs to the latter one. We know the difficulties to treat this pathology in the fields of surgery and speech therapy mostly because of misunderstanding VP physiology and physiopathology, which are complex. Then aerophonoscopy allows us to understand this complexity. So we are able to easily assess excessive Nasal Loss -NL- factors. The NL is linked mainly with a VPS persistent lack of closing, of course. But it varies according to its stiffness, tonicity, and its smaller and slower movements. The latters are according to each phoneme or syllable, and they have more or less speedy succession of the “phonological verbal chain”. So we aim at presenting this instrument that enables an aerodynamic assessment of the VPS precisely. We can analyse many characteristics of its pathological movements with different tests in our protocol (passive, active, effort, successive movements and so on) and show the results of about 652 individuals. These data contribute to guide therapeutic decisions, (choice of type of surgery, targets of rehabilitation), such as to restore the VPS physiology at the very most. Furthermore, it provides a pleasant and efficient means of rehabilitation of the VPS