Learning objectives
Identify the anatomical components that lead to normal velopharyngeal function.
Provide a brief description of how to do the video-fluoroscopic procedure for the evaluation of velopharyngeal insufficiency.
Enunciate the measurements and descriptors that the imaging report needs to include.
Background
Normal velopharyngeal function depends on three major components which are: anatomy, physiology, and speech learning. Velopharyngeal closure requires normal velopharyngeal structure and adequate velopharyngeal function (neurophysiology), however, is often forgotten that the velopharyngeal valve is an articulator, just like the tongue and lips. As such, there is also a learned component to velopharyngeal function [1].
Velopharyngeal dysfunction (VPD) is known as the condition where the velopharyngeal port does not close completely during the production of oral sounds is used as a broad term that includes...
Findings and procedure details
1.- ANATOMY AND PHYSIOLOGY
The velopharyngeal sphincter is constituted primarily of a muscular valve that extends from the posterior surface of the hard palate (roof of mouth)to the posterior pharyngeal wall. It is composed of three major elements:
The velum, also known as soft palate. See (Figure 1).[Fig 1]
Posterior pharyngeal wall (back wall of the throat) [3]. See (Figure 1).
Lateral pharyngeal walls (sides of the throat). See (Figure 2).[Fig 2]
The function of this mechanism is to create a tight seal by elevating...
Conclusion
Adequate velopharyngeal closure depends on several anatomic and physiological mechanisms. Familiarization with the radiological anatomy and how to perform videofluoroscopy of the velopharyngeal sphincter combined with videonasopharyngoscopy can be one of the best approaches when planning a surgical correction of Velopharyngeal insufficiency.
Personal information and conflict of interest
S. J. Valdes Bañuelos:
Nothing to disclose
M. Cuadra:
Nothing to disclose
H. A. Cervantes Flores:
Nothing to disclose
F. Bravo Ontiveros:
Nothing to disclose
References
Kummer AW. Types and Causes of Velopharyngeal Dysfunction.
Silver AL, Nimkin K, Ashland JE, Ghosh SS. Cine Magnetic Resonance Imaging With Simultaneous Audio to Evaluate Pediatric Velopharyngeal Insufficiency. ARCH OTOLARYNGOL HEAD NECK SURG. 2011;137(3).
Perry JL. Anatomy and Physiology of the Velopharyngeal Mechanism. Semin SPEECH Lang. 2011;32(2).
Ysunza PA. Velopharyngeal videofluoroscopy: Providing useful clinical information in the era of reduced dose radiation and safety. Int J Pediatr Otorhinolaryngol. 2016;
Skolnick ML, Cohn ER. Videofluoroscopic Studies of Speech in Patients with Cleft Palate. New York, NY:...