VELOPHARYNGEAL AIRWAY-RESISTANCE DISORDERS AFTER TRAUMATIC BRAIN INJURY

Objective: Disorders affecting velopharyngeal port closure may result in the perception of hypernasality. This study was designed to determi ne (1) the incidence of velopharyngeal airway resistance deficits afte r traumatic brain injury, (2) the relation between velopharyngeal airw ay resistance and dysarthria severity, and (3) the relation between ve lopharyngeal airway resistance and perceived hypernasality. Design: Ca se series. Setting: Community re-entry residential rehabilitation prog ram. Patients: Eighty-three consecutive referrals for speech productio n evaluations. Main Outcome Measures: Velopharyngeal airway resistance at the time of the evaluation. Results: About half the patients evide nced reduced velopharyngeal airway resistance. Subjects who evidenced mild or absent dysarthria typically had no velopharyngeal deficits, wh ile subjects who evidenced severe dysarthria had very low velopharynge al airway resistance. With few exceptions, the severity of the velopha ryngeal airway resistance deficit was associated with perceived hypern asality. Conclusions: Velopharyngeal airway resistance disorders after traumatic brain injury are common. Discrepancies between velopharynge al airway resistance and perceived hypernasality may be caused by inte lligibility, speaking style, or nonrepresentative sampling. (C) 1998 b y the American Congress of Rehabilitation Medicine and the American Ac ademy of Physical Medicine and Rehabilitation.