Lateral Pharyngeal-Wall Motion as a Predictor of Surgical Success in Velopharyngeal Insufficiency

Abstract

Separation of the oral and nasal cavities is essential for normal speech. This separation is in part accomplished by sphincteric action of the lateral pharyngeal walls. A prospective study of 67 patients with velopharyngeal insufficiency carried out with radiographic and ultrasonic measurements of lateral pharyngeal-wall motion showed that patients with velopharyngeal insufficiency could be divided into three distinct groups based on ratings of lateral pharyngeal-wall motion. The preoperative and postoperative performance indexes of nasality, nasal emission, and speech intelligibility were compared in all three groups. The greatest improvement was in patients with normal or near normal motion of the lateral pharyngeal wall. Thus, rating of lateral pharyngeal-wall motion can be made reliably. These ratings should be a routine part of the assessment of velopharyngeal incompetency, and have predictive value in the determination of the success of velopharyngeal-flap surgery.