Revista CEFAC
https://revistacefac.org.br/article/doi/10.1590/1982-0216/20242660424
Revista CEFAC
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Anatomical and functional characterization of the hypodynamic velopharynx in individuals with cleft palate

Caracterização anatomofuncional da velofaringe hipodinâmica em indivíduos com fissura de palato

Crislayne Melo da Silva; Maria Inês Pegoraro-Krook; Jeniffer de Cássia Rillo Dutka

http://dx.doi.org/10.1590/1982-0216/20242660424 Revista CEFAC, vol.26, n6, e0424, 2024
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Abstract

Purpose: to characterize the velopharyngeal function of individuals presented with velopharyngeal dysfunction, suggestive of a hypodynamic velopharynx.

Methods: the sample comprised nasoendoscopy examinations from adult subjects with repaired cleft palate, no fistula, velopharyngeal dysfunction, and a probable diagnosis of hypodynamic velopharynx. All participants used a pharyngeal bulb prosthesis and had never undergone speech therapy for velopharyngeal dysfunction. Three speech-language pathologists assessed the movement of velopharyngeal structures. The results were analyzed using descriptive statistics, the Kappa being employed to measure intra-rater agreement.

Results: out of the 28 recordings, 23 (82%) exhibited minimal mobility of the soft palate and lateral pharyngeal walls, with a large residual velopharyngeal gap. Additionally, 23 (82%) showed no antagonistic movement, and the Passavant's ridge was present in 7 (25%). Regarding the type, 16 (57%) had a circular gap, 8 (28%) had a circular gap with a Passavant´s ridge, 3 (10%) had a coronal gap, and 1 (5%) had a sagittal one. There was no movement of the posterior pharyngeal wall in 14 (50%) recordings. Agreement was considered almost perfect for all aspects analyzed (Kappa = 1.00).

Conclusion: subjects presented with velopharyngeal dysfunction, indicative of a hypodynamic velopharynx, exhibited a velopharyngeal gap equal to or greater than 50% of the resting size of the velopharyngeal space, with minimal movement of the soft palate and pharyngeal walls.

Keywords

Cleft Palate; Velopharyngeal Insufficiency; Palatal Obturators; Speech

Resumo

Objetivo: caracterizar o funcionamento velofaríngeo de indivíduos que apresentam disfunção velofaríngea sugestiva de velofaringe hipodinâmica.

Métodos: a amostra foi constituída por exames de nasoendoscopia, de indivíduos adultos com palato operado, sem fístula, com disfunção velofaríngea e provável diagnóstico de velofaringe hipodinâmica. Todos os indivíduos utilizavam obturador faríngeo e nunca haviam realizado terapia fonoaudiológica para tratamento da disfunção velofaríngea. Três fonoaudiólogas avaliaram o movimento das estruturas velofaríngeas. Os resultados foram analisados por meio de estatística descritiva e o Teste de Kappa foi utilizado para calcular a concordândia intra-avaliador.

Resultados: das 28 gravações, 23 (82%) apresentaram mobilidade mínima do véu palatino e paredes laterais, com gap velofaríngeo residual grande. Além disso, 23 (82%) não apresentaram movimento antagônico e o anel de Passavant estava presente em 7 (25%). Quanto ao tipo de gap, 16 (57%) apresentaram gap circular, 8 (28%) gap circular com anel de Passavant, 3 (10%) gap coronal e 1 (5%) gap sagital. Não houve movimentação da parede posterior da faringe em 14 (50%) gravações. A concordância foi considerada quase perfeita para todos os aspectos analisados (Kappa = 1,00).

Conclusão: sujeitos com disfunção velofaríngea indicativa de uma velofaringe hipodinâmica apresentaram gap velofaríngeo igual ou acima de 50% do tamanho do espaço velofaríngeo em repouso, com movimento mínimo do véu palatino e das paredes faríngeas.

Palavras-chave

Fissura Palatina; Insuficiência Velofaríngea; Obturadores Palatinos; Fala

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Submitted date:
01/29/2024

Accepted date:
06/04/2024

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