Laryngeal/voice findings in patients with velopharyngeal dysfunction.
It is reported frequently that individuals with palatal clefts have a high occurrence of laryngeal/voice symptoms. It has been speculated that vocal pathology in this population is the result of laryngeal compensation for abnormal velopharyngeal valving. This paper describes the prevalence of laryngeal/voice findings in a group of 85 patients referred for multimethod evaluation of velopharyngeal dysfunction. Forty-one percent of the patients had auditorily perceived voice symptoms and/or observable laryngeal abnormalities. Twenty-one percent of the patients had vocal fold nodules or thickened vocal folds. There was no clear relationship between laryngeal/voice findings and nasoendoscopic or aerodynamic assessments of velopharyngeal dysfunction. However, there was a significant relationship between laryngeal/voice findings and estimated subglottal pressure. Patients with laryngeal/voice findings (with or without nodules) had average estimated subglottal pressure values which were outside the normal range more often than patients without laryngeal/voice findings. These results suggest patients referred for assessment of velopharyngeal dysfunction should receive a comprehensive evaluation which includes screening laryngeal structure and function.
D'Antonio
L L
LL
Department of Otolaryngology, Washington University Medical Center, St. Louis, MO.
Muntz
H R
HR
Province
M A
MA
Marsh
J L
JL
D001307:Auditory Perception; D002972:Cleft Palate / Q000150:complications*; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000150:complications*; D007828:Laryngoscopy; D008297:Male; D013067:Speech Perception; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis / Q000209:etiology*; D014827:Vocal Cords / Q000473:pathology