title: [Perceptual and instrumental assessment of velopharyngeal function in asymptomatic submucous cleft palate].
abstract: BACKGROUND
  submucous cleft palate (SMCP) may or may not be associated to symptoms of velopharyngeal dysfunction (VPD).
  
  
  OBJECTIVE
  to verify whether patients with SMCP, who were considered as asymptomatic on a perceptual speech evaluation, present absence of hypernasality and adequate velopharyngeal closure on an instrumental assessment.
  
  
  METHODS
  22 patients with SMCP and with no VPD symptoms, of both genders, aged 6 to 46 years, underwent speech acoustic assessment (nasometry)--to determine nasalance scores--and speech aerodynamic assessment (pressure-flow technique)--to verify velopharyngeal closure. The complete agreement between the findings on the perceptual and instrumental assessments was the tested null hypothesis.
  
  
  RESULTS
  the pressure-flow technique confirmed the perceptual findings, that is, all patients were diagnosed as having adequate velopharyngeal function on both types of assessment. Nasometry results confirmed the perceptual findings in 15 out of the 20 analyzed patients (75% of the cases). The remaining 5 patients (25%) presented nasalance scores that suggest hypernasality (nasometry). This symptom was not identified by the perceptual evaluation, yielding to the rejection of the null hypothesis.
  
  
  CONCLUSIONS
  results indicate the importance of the combined use of perceptual and instrumental assessments for the diagnosis of VPD in SMCP cases. The follow-up of patients diagnosed as asymptomatic by a perceptual speech evaluation and presenting evidences of VPD on instrumental assessment (e.g. nasometry) is recommended, particularly when dealing with children who are more prone to develop symptoms with aging.
authors.affiliation: Hospital de Reabilitação de Anomalias Craniofaciais (HRCA), Universidade de São Paulo. halinemiguel@hotmail.com
authors.forename: Haline Coracine
authors.initials: HC
authors.lastname: Miguel
authors.forename: Kátia Flores
authors.initials: KF
authors.lastname: Genaro
authors.forename: Inge Elly Kiemle
authors.initials: IE
authors.lastname: Trindade
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002972:Cleft Palate / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D023842:Rhinometry, Acoustic; D013061:Speech Acoustics; D013068:Speech Production Measurement / Q000379:methods*; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis*