Cleft Palate Exam 3
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| What are indirect measures? | Do not allow for direct visualization, but provide objective data for VP function
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| Two types of indirect measure of VPI | Nasometry and aerodynamic pressure flow
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| What are direct measures? | Visualize aspects of velopharyngeal function but still requires interpretation
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| Two types of direct measures of VPI | Speech videofluotoscopy, Nasopharyngoscopy
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| What is Nasometry? | Measures amount of nasal acoustic energy in a person's speech, gives nanogram
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| Nasalance | A measure of nasal energy
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| Two advantages of nasometry | Easy to use, non-invasive, normative data for comparison, biofeedback
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| Two disadvantages of nasometry | Cost of machine, difficult to properly fit mask
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| What is aerodynamic pressure flow? | Measures oral air pressure, nasal air pressure, and rate of nasal airflow
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| Two advantages of aerodynamic pressure flow | Minimally invasive, objective data for multiple measures, minimal patient risk
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| Two disadvantages of aerodynamic pressure flow | Cost, difficult to use, lots of equipment to fit
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| What is video fluoroscopy? | Similar to MBSS but barium is in the nasal cavity, used to visualize structures during speech and at rest
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| Two advantages of videofluoroscopy? | Obtain images in multiple views (lateral, frontal, etc.), easy to conduct, good for velar length, closure, shape
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| Two disadvantages of video fluoroscopy | Radiation (exam <3 mins.), difficult to record sound and synchronize with image, invasive
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| Nasopharyngoscopy (flexible nasal endoscope) | ENT does this, flexible scope through nasal cavity to view VP port
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| Advantages for nasopharyngoscopy | View VP closure dynamically, can see exact measures of VP gap, phoneme specific emissions
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| Disadvantages for nasopharyngoscopy | invasive, high level of cooperation required, costly equipment, if need anesthetic can't eat or drink after
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| What is magnetic Resonance Imaging? | Post-surgery when suspect VPIdue to attachment of elevator fibers to hard palate, confirms sub mucous cleft, whole head scan
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| Clinical application of MRI | Only way to see muscle working in living person
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| Where do you refer a child with resonance issues, regardless of cleft? | Cleft craniofacial team and SLP, not ENT
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| Where do you refer a child with speech errors unique to cleft speech, regardless of cleft? | SLP who specializes in resonance, not ENT
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| Why don't refer to ENT? | They're not as good at diagnosis with this kids
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