VIDEONASOPHARYNGOSCOPY AS AN INSTRUMENT FOR VISUAL BIOFEEDBACK DURINGSPEECH IN CLEFT-PALATE PATIENTS

Videonasopharyngoscopy was used as an instrument for visual biofeedbac k during speech in deft palate patients. Seventeen cleft palate patien ts were randomly selected for the study. All patients showed velophary ngeal insufficiency (VPI), compensatory articulation (CA) and negative movement of lateral pharyngeal walls (NMLPW) during speech. Nine pati ents received speech therapy for correcting CA. Eight patients receive d speech therapy and underwent videonasopharyngoscopy as an instrument for visual biofeedback of the velopharyngeal sphincter, After 12 week s, NMLPW was modified in the patients receiving speech therapy and vis ual biofeedback. In contrast, NMLPW was still present in eight out of nine patients receiving only speech therapy. These patients received v isual biofeedback and NMLPW was corrected in all cases. After six mont hs, all 17 patients had corrected CA during isolated speech. All patie nts received a tailor-made pharyngeal flap. VPI was completely correct ed in 15 cases. In the two cases in which VPI was still present postop eratively, the size of the defect at the velopharyngeal sphincter had been significantly reduced. In these two patients, visual biofeedback was used postoperatively for increasing lateral pharyngeal walls (LPW) motion towards the borders of the flap. After 18 months since the ons et of speech therapy all the patients had normal nasal resonance and n ormal articulation during connected speech. (C) 1997 Elsevier Science Ireland Ltd.