The evolution of velopharyngeal imaging

Currently, functional visualization of the velopharynx requires tests that are either invasive (endoscopy) or that impart ionizing radiation(speech vi deofluoroscopy), The overall intrusiveness of endoscopy may limit its clini cal utility, especially in young children. As a resut of growing awareness of the long-range effects of radiation exposure associated with X-ray imagi ng, radiographic research on subjects and studies not judged to be clinical ly necessary have been all but abandoned, The static nature of lateral radi ographs precludes temporal assessment, and the two dimensionally of images derived from both of these diagnostic modalities may limit understanding of spatial anatomic relationships and may preclude quantitative analysis, The need for a noninvasive, rapid, and easily repeatable method for examinatio n of the velopharynx has fomented the innovative application of existing te chnologies, especially magnetic resonance imaging. We present an updated ov erview of techniques for imaging the velopharyngeal mechanism, with a focus on residual velopharyngeal dysfunction after initial palatoplasty. We prov ide a comprehensive perspective of the role of currently available instrume ntation, summarize the work in our center regarding the technological devel opments of magnetic resonance imaging, and speculate about future applicati ons of magnetic resonance imaging systems for evaluation of velopharyngeal dysfunction. The limitations of each of these measures discussed are emphas ized.