Abstract
Quantitative measurement of lateral pharyngeal wall movement is necessary to evaluate the degree of velopharyngeal closure in patients with cleft palate and other velopharyngeal incompetency. Various methods involving video or cineflurography have been utilized to determine the configuration and movement of the lateral pharyngeal wall during speech and other activities. However, those have not always revealed the nature of the entire lateral pharyngeal wall because of the bony structure overlying the pharynx. In 1975, Skolnick et al. reported preliminary inventigations of a new technique using multitransducer ultrasonic equipment to assess the dynamics of lateral pharyngeal wall movement, but no reports have been published dealing with quantitative studies of lateral pharyngeal wall movement in cleft palate patients using this equipment.
The purpose of this report is to exhibit the utility of multitransducer ultrasonic equipment for the diagnosis of velopharyngeal function in cleft palate patients and velopharyngeal incompetence patients. Five patients with repaired cleft palate (one male and four females 15-33 years. ), three patients w ith unrepaired cleft palate (all females 32-52 years), four patients with congenital velopharyngeal incompetency in the absence of a repaired cleft palate (two males and two females 13-20 years) and five normal subjects (one male and four females 27-32 years) were used as subjects for these experiments. Each subject sat in a dental chair with head immobilized so that the hard palate was positioned approximately horizontally, and the vowel /a/, /i/, and swallowing.
Each case of cleft palate and velopharyngeal incompetency showed uncoordinated activity in the lateral pharyngeal wall during phonation, but with a similar pattern in comparison with normal subjects. During swallowing, the medial movement of the lateral pharyngeal wall was comparable to that of normal subjects. In all cases, the clearly observal information provided by the echograms suggests that use of multitransducer ultrasonic equipment to assess the dynamics of lateral pharyngeal wall movement may be successfully applied in quantitative studies involving cleft palate and other velopharyngeal incompetency.
