Velopharyngeal dysfunction: a systematic review of major instrumental and auditory-perceptual assessments

Summary

Introduction: Velopharyngeal dysfunction may cause impaired verbal communication skills in individuals with cleft lip and palate; thus, patients with this disorder need to undergo both instrumental and auditory-perceptual assessments.

Objective: To investigate the main methods used to evaluate velopharyngeal function in individuals with cleft lip and palate and to determine whether there is an association between videonasoendoscopy results and auditory-perceptual assessments.

Method: We conducted a systematic review of the literature on instrumental and auditory-perceptual assessments. We searched the PubMed, Medline, Lilacs, Cochrane, and SciELO databases from October to November 2012.

Summary of findings: We found 1,300 studies about the topic of interest published between 1990 and 2012. Of these, 56 studies focused on velopharyngeal physiology; 29 studies presented data on velopharyngeal physiology using at least 1 instrumental assessment and/or 1 auditory-perceptual assessment, and 12 studies associated the results of both types of assessments. Only 3 studies described in detail the analysis of both methods of evaluating velopharyngeal function; however, associations between these findings were not analyzed.

Conclusion: We found few studies clearly addressing the criteria chosen to investigate velopharyngeal dysfunction and associations between videonasoendoscopy results and auditory-perceptual assessments.

Keywords

Cleft Palate - Communication Disorders - Velopharyngeal Sphincter

• References

• 1 Peterson-Falzone SJ, Hardin-Jones MA, Karnell MP. Communication disorders associated with cleft palate. In: Peterson-Falzone SJ, Hardin-Jones MA, Karnell MP, , editors. Cleft Palate Speech. 3rd ed. Missouri: Mosby; 2001. p. 162–99
• 2 Rocha DL, Insuficiência Velofaríngea. In: Mélega JM. Cirurgia Plástica: Fundamentos e Arte - Cirurgia reparadora de Cabeça e Pescoço. Rio de Janeiro: Medsi; 2002. p. 178–96
• 3 Golding-Kushner KJ , et al. Standartization for the reporting of nasopharyngoscopy and multiview videofluoroscopy: a report from an international working group. Cleft Palate J 1990; 27: 337-48
• 4 Conley SF, Gosain AK, Marks SM, Larson DL. Identification and assessment of velopharyngeal inadequacy. Am J Otolaryngol 1997; 18: 38-46
• 5 Shprintzen RJ. Instrumental Assessment Of Velopharyngeal Valving. In: Shprintzen RJ, Bardach J. Cleft palate speech management: A multidisciplinary approach. St. Louis: Mosby; 1995. p. 221–56
• 6 Trindade IEK, Trindade JAS. Avaliação funcional da inadequação velofaríngea. In: Carreirão S, Lessa S, Zanini AS, , editors. Tratamento das fissuras labiopalatinas. 2nd ed. Rio de Janeiro: Editora Revinter; 1996. p. 223–35
• 7 Sell D, Harding A, Grunwell P. A screening assessment of cleft palate speech (Great Ormond Street Speech Assesmente). Eur J Disord Commun 1999; 29: 1-15
• 8 Genaro KF, Yamashita RP, Trindade IKE. Avaliação clínica e instrumental na fissura labiopalatina. In: Ferreira LP, Befi-Lopes DM, Limongi SCO. Tratado de Fonoaudiologia. São Paulo: Rocca; 2004. p. 456–77
• 9 Laczi E, Sussman JE, Stathopoulos ET, Huber J. Perceptual evaluation of hypernasality compared to HONC measures: The role of experience. Cleft Palate Craniofac J 2005; 42: 202-10
• 10 Pontes PAL, Behlau MS. Nasolaringoscopia. In: Altmann EBC. Fissuras labiopalatinas. 4th ed. Carapicuíba: Pró-fono; 2005. p. 175–83
• 11 Kuehn DP, Henne LJ. Speech Evaluation and Treatment for Patients With Cleft Palate. Am J Speech Lang Pathol 2003; 12: 103-9
• 12 Shprintzen RJ. Nasopharyngoscopy. In: Bzoch KR, , editors. Communicative Disorders Related To Cleft Lip And Palate. 5th ed. Boston: Little & Brown; 2004
• 13 Williams WN, Heningsson G, Pegoraro-Krook MI. Radiographic assessment of Velopharyngeal function for speech. In: Bzoch KR, , editor. Communicative disorders related to cleft lip and palate. 5th ed. Boston: Little & Brown; 2004
• 14 Klassen AF, Tsangaris E, Forrest CR, Wong KWY, Pusic AL, Cano SJ , et al. Quality of life of children treated for cleft lip and/or palate: A systematic review. J Plast Reconstr Aesthet Surg 2012; 65: 547-57
• 15 Sampaio RF, Mancini MC. Estudos De Revisão Sistemática: Um Guia Para Síntese Criteriosa Da Evidência Científica. Rev. Bras. Fisioter 2007; 11: 83-9
• 16 Camargo LOS, Rodrigues MC, Avelar JA. Oclusão velofaríngea em indivíduos submetidos à nasoendoscopia na Clínica de Educação para Saúde (CEPS). Salusvita 2001; 20: 35-47
• 17 Chanchareonsook N, Whitehill TL, Samman N. Speech outcome and velopharyngeal function in cleft palate: comparison of Le Fort I maxillary osteotomy and distraction osteogenesis—early results. Cleft Palate Craniofac J 2007; 44: 23-32
• 18 Kao DS, Soltysik DA, Hyde JS, Gosain AK. Magnetic Resonance Imaging as an Aid in the Dynamic Assessment of the Velopharyngeal Mechanism in Children. Plast Reconstr Surg 2008; 122: 572-7
• 19 Marsh J. Velo-pharyngeal dysfunction: Evaluation and management. Indian J Plast Surg 2009; 42: 129-36
• 20 Miguel HC, Genaro KF, Trindade IEK. Avaliação perceptiva e instrumental da função velofaríngea na fisura de palato submucosa assintomática. Pró-Fono Revista de Atualização Científica 2007; 19: 105-12
• 21 Nagarajan R, Savitha VH, Subramaniyan B. Communication disorders in individuals with cleft lip and palate: An overview. Indian J Plast Surg 2009; 42: 137-43
• 22 Netto BCA, Cervantes O. Estudo comparativo entre pacientes fissurados portadores de insuficiência velofaríngea tratados com fonoterapia e faringoplastia. Rev Bras Cir Plást 2011; 26: 631-8
• 23 Penido FA, Noronha RMS, Caetano KI, Jesus MSV, Di Ninno CQMS, Britto ATBO. Correlação entre os achados do teste de emissão de ar nasal e da nasofaringoscopia em pacientes com fissura labiopalatina operada. Rev Soc Bras Fonoaudiol 2007; 12: 126-34
• 24 Shprintzen RJ, Marrinan EMS. Velopharyngeal insufficiency: diagnosis and management. Curr Opin Otolaryngol Head Neck Surg 2009; 17: 302-7
• 25 Shyammohan A, Sreenivasulu D. Speech Therapy with Obturator. J Indian Prosthodont Soc 2010; 10: 197-9
• 26 Trindade IEK, Genaro KF, Yamashita RP, Miguel HC, Fukushiro AP. Proposta de classificação da função velofaríngea na avaliação perceptivo-auditiva da fala. Pró-Fono Revista de Atualização Científica 2005; 17: 259-62
• 27 Qi C, Qian Z, Bing S, Heng Y, Tian M, Guang-ning Z. Study of relationship between clinical factors and velopharyngeal closure in cleft palate patients. J Res Med Sci 2011; 16: 945-50