title: Comparative analysis of velopharyngeal activity assessed by acoustic rhinometry and rhinomanometry.
abstract: OBJECTIVE
  To analyze the velopharyngeal (VP) activity of subjects with velopharyngeal dysfunction (VPD) by acoustic rhinometry, as compared to rhinomanometry.
  
  
  METHODS
  This was a prospective clinical study conducted in 41 adults, both genders, with repaired cleft palate, with or without a previously repaired cleft lip, and residual VPD on clinical assessment, without compensatory articulations for [p], [t], and [k]. The outcome measures were as follows: (1) on acoustic rhinometry, nasopharyngeal volumetric change (ΔV) during [p], [t], and [k], relatively to rest condition (decreases by <3 cm3 considered as absence of VP activity); (2) on modified anterior rhinomanometry, VP orifice area (areas ≥0.05 cm2 considered as inadequate closure). The plosive [p] was used when comparing the techniques (n=24).
  
  
  RESULTS
  (1) A mean ΔV decrease of 18% was observed during [k], which was significantly lower (p<0.05) than the decrease reported for individuals without VPD (30%). ΔV values suggesting VPD were observed in 59% subjects. Similar results were obtained for [p] and [t], which shall be used as stimulus, given that they do not involve the use of the tongue to lift the velum during VP closure, differently from the velar plosive [k]. (2) Inadequate closure was seen in 85% subjects. No correlation was observed between ∆V and VP orifice area. Agreement between techniques was observed in 51% cases.
  
  
  CONCLUSIONS
  Acoustic rhinometry had low accuracy as a diagnostic method of VPD when compared to the gold standard method. Nevertheless, the technique shows potential as a method for monitoring the outcomes of clinical and surgical treatment of VPD aimed at increasing velar and pharyngeal activity.
authors.affiliation: Laboratório de Fisiologia, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil.
authors.forename: Alícia Graziela Noronha Silva
authors.initials: AG
authors.lastname: Salgueiro
authors.affiliation: Laboratório de Fisiologia, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil.
authors.forename: Andressa Sharllene Carneiro da
authors.initials: AS
authors.lastname: Silva
authors.affiliation: Laboratório de Fisiologia, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil.
authors.forename: Bruna Mara Adorno Marmontel
authors.initials: BM
authors.lastname: Araújo
authors.affiliation: Laboratório de Fisiologia, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil.
authors.forename: Renata Paciello
authors.initials: RP
authors.lastname: Yamashita
authors.affiliation: Laboratório de Fisiologia, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil.
authors.forename: Inge Elly Kiemle
authors.initials: IE
authors.lastname: Trindade
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002971:Cleft Lip / Q000503:physiopathology; D002972:Cleft Palate / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D025363:Rhinomanometry / Q000295:instrumentation / Q000379:methods*; D023842:Rhinometry, Acoustic / Q000295:instrumentation / Q000379:methods*; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult