Velopharyngeal Activity Research Articles

Influence of tonsils on velopharyngeal movements in children with craniofacial anomalies and hypernasality

Velopharyngeal activity and tongue and tonsil movements were examined cineradiographically in the connected speech of 40 hypernasal children with craniofacial disorders—20 with small tonsils and 20 with large tonsils. The tonsils were defined as large when they obstructed two thirds or more of the pharyngeal space; they were considered small if the obstruction was one fourth or less of the pharyngeal space. In patients with small tonsils, consistent velopharyngeal activity was seen most of the time, regardless of the position of the back of the tongue during speech. An association between large tonsils and decreased velopharyngeal activity was found for speech sounds articulated in the back of the mouth. Therefore when examining velopharyngeal activity in hypernasal children, it is important that the speech material include syllables and words with speech sounds articulated in the back of the mouth.

A Comparison of Photodetector and Endoscopic Evaluations of Velopharyngeal Function

Simultaneous videoendoscopic and photodetection analyses were made of specific onset and offset times of velopharyngeal opening and closing in two normal speaking subjects. Both procedures were found to have acceptable measurement repeatability and to agree with each other when used to determine movement changes. It is felt that when used together, these techniques contribute to improved understanding of velopharyngeal activity during speech.

Comparison of cineradiographic and photodetection techniques for assessing velopharyngeal function during speech.

This study investigated the extent to which high-speed lateral-view cineradiography and a photodetector system described by Dalston (1982) provided comparable information concerning velopharyngeal activity. We observed the production of isolated utterances and running speech for 2 subjects in three contexts. A comparison was made between the times at which the velopharyngeal port was observed by each method to begin opening, reach maximal opening, begin closing, and initially attain closure. The photodetector system was found to be sensitive to changes in velar position observed by cineradiography. The correlation between the magnitude of photodetector output and the magnitude of velar displacement from the posterior pharyngeal wall was .89 for Subject 1 and .78 for Subject 2. The lack of a perfect relation between the output of the photodetector device and movements of the velum observed by cineradiography was not unexpected given the two-dimensional limitation of lateral cineradiography and the complexity of events associated with changing port size. The significance of these findings is discussed with respect to the potential research and clinical uses of this photodetector system.

Influence of Palatal Fistulas on Velopharyngeal Movements

Ten patients with hard palate fistulas and velopharyngeal incompetence were examined cineradiographically with lateral and frontal projections during connected speech. The purpose was to study velopharyngeal function for open versus covered fistulas. Fistula length, width, and size were measured. With an open fistula, the degree of lateral pharyngeal wall activity was significantly correlated at the 0.05 level to fistula size. There was no statistically significant correlation between fistula size and the degree of velar activity. With the fistula covered, the velopharyngeal movements improved or even normalized in all patients regardless of fistula size. These findings indicate that patients with both velopharyngeal incompetence and an additional fistula will need covering of the fistula. If velopharyngeal incompetence persists after a temporary covering of the fistula, a combination of velopharyngeal flap surgery and fistula covering ought to be performed to normalize the velopharyngeal activity and speech and resonance.

Visual training for velopharyngeal closure in cleft palate patients; a fihrescopic procedure (preliminary report)

Velopharyngeal closure in various tasks was examined in 59 cleft palate patients with persistent velopharyngeal incompetence using nasopharyngeal fibrescopic (NPF) examination. The degree of velopharyngeal closure was analyzed according to the categories reported previously by Yamaoka (1973) and Matsuya et al. (1979). The NPF self-training system was developed and applied to those patients so as to investigate a longitudinal effect of the NPF in velopharyngeal closure mechanism. The training was performed every two weeks for nearly one year. The results indicated that the patient who showed complete velopharyngeal closure during blowing and/or several productions of speech samples could attain a much better improvement in all speech samples after one year of self-training. On the other hand, the patients who did not show complete velopharyngeal closure during all tasks, failed to improve the velopharyngeal closing mechanism. The ability to close the velopharynx during swallowing was seen in all patients examined. However, it appeared to have nothing to do with the prognosis of velopharyngeal closure. The data suggested that the NPF self-training system provided a strong neuro-muscular signal for velopharyngeal movement. Besides, it was considered that the NPF was a useful tool for activation of velopharyngeal activity by way of visual feed-back control.

Nasalance patterns in esophageal speech

Velopharyngeal activity during esophageal speech was investigated indirectly by use of TONAR II instrumentation, which measures the oral-nasal acoustic ratio. Eight very good esophageal speakers who used an injection type of insufflation served as subjects. Each subject read three standardized passages containing varying amounts of nasal consonants. The results indicated that these speakers have a slower, but functional, velopharyngeal mechanism.

The clinical use of the Taub oral panendoscope in the observation of velopharyngeal function.

Observation of velopharyngeal activity is facilitated by the use of the Taub oral panendoscope coupled to videotape equipment. The procedure permits visualization of the velopharyngeal structures during rest, speech, and nonspeech activities. It allows easy synchronization of audio and video signals, immediate playback, and permanent storage of data. The success of oral panendoscopy depends, in part, on the preparation by the examiner and on the procedures used in conducting the examination. While there are restrictions and limitations to oral panendoscopy, it appears to have significant clinical potential.

Relationship of Lingual and Intraoral Air Pressure during Consonant Production

Variations of intraoral air pressure associated with the production of different consonants may be due to resistance created by the tongue to respiratory air flow. One indicator of tongue resistance is the pressure it exerts against other oral structures during speech. The purpose of this study was to obtain simultaneous recordings of lingual pressure and air pressure to aid in determining if a relationship does exist between these two intraoral pressures. Nine young adult males repeated syllables containing /t/, /d/, and /n/ consonants placed in the initial, medial, and final syllabic position. Measurement of these recordings showed greatest air-pressure values for /t/, less for /d/, and least for /n/. Lingual pressure values did not follow the same systematic trend; greatest pressure values were found for /t/, but no difference was found between /d/ and /n/. These results suggest that—whereas varying tongue pressures may account, in part, for variations in air pressure—other physiological systems such as respiratory, laryngeal, and velopharyngeal activity also interact to account for varying air pressures.