Alana Verza Signorini

Velopharyngeal dysfunction: a systematic review of major instrumental and auditory-perceptual assessments

Summary Introduction: Velopharyngeal dysfunction may cause impaired verbal communication skills in individuals with cleft lip and palate; thus, patients with this disorder need to undergo both instrumental and auditory-perceptual assessments. Objective: To investigate the main methods used to evaluate velopharyngeal function in individuals with cleft lip and palate and to determine whether there is an association between videonasoendoscopy results and auditory-perceptual assessments. Method: We conducted a systematic review of the literature on instrumental and auditory-perceptual assessments. We searched the PubMed, Medline, Lilacs, Cochrane, and SciELO databases from October to November 2012. Summary of findings: We found 1,300 studies about the topic of interest published between 1990 and 2012. Of these, 56 studies focused on velopharyngeal physiology; 29 studies presented data on velopharyngeal physiology using at least 1 instrumental assessment and/or 1 auditory-perceptual assessment, and 12 studies associated the results of both types of assessments. Only 3 studies described in detail the analysis of both methods of evaluating velopharyngeal function; however, associations between these findings were not analyzed. Conclusion: We found few studies clearly addressing the criteria chosen to investigate velopharyngeal dysfunction and associations between videonasoendoscopy results and auditory-perceptual assessments.

Comparison of videonasoendoscopy and auditory-perceptual evaluation of speech in individuals with cleft lip/palate

Summary Introduction: The velopharyngeal sphincter (VPS) is a muscle belt located between the oropharynx and the nasopharynx. Investigations of velopharyngeal function should include an auditory-perceptual evaluation and at least 1 instrument-based evaluation such as videonasoendoscopy. Aim: To compare the findings of auditory-perceptual evaluation (hypernasality) and videonasoendoscopy (gap size) in individuals with cleft lip/palate. Method: This was a retrospective, cross-sectional study assessing 49 subjects, of both sexes, with cleft lip/palate followed up at the Otorhinolaryngology Service and the Speech Therapy outpatient clinic of Hospital de Clínicas de Porto Alegre (HCPA). The results from the auditory-perceptual evaluation and the videonasoendoscopy test were compared with respect to the VPS gap size. Results: Subjects with moderate/severe hypernasality had more severe velopharyngeal closure impairment than those with a less severe condition. The interaction between hypernasality severity and the presence of other speech disorders (p = 0.035), whether compensatory and/or obligatory, increased the likelihood of having a moderate-to-large gap in the velopharyngeal closure. Conclusions: We observed an association between the findings of these 2 evaluation methods.

Ressonância magnética funcional e deglutição: revisão sistemática

Objetivo Avaliar a viabilidade e seguranca da ressonância magnetica funcional para a avaliacao de areas corticais envolvidas na degluticao. Estrategia de pesquisa Conduziu-se uma busca entre abril de 2003 e abril de 2013, usando as palavras chave “functional magnetic resonance imaging” or“fMRI” and “dysphagia” e“functional magnetic resonance imaging” or“fMRI” and “swallowing” na base de dados PubMed. Criterios de selecao Os estudos foram revisados por analise de seus titulos eabstracts e os criterios de inclusao utilizados foram: pesquisas envolvendo seres humanos, utilizacao de exames neurofuncionais, referencia a funcao de degluticao, analise de populacao adulta e/ou idosa, relacao com patologias neurologicas. Resultados A estrategia de busca resultou em 1167 citacoes, das quais apenas 35 preencheram os criterios de elegibilidade. Conclusao A ressonância magnetica funcional foi considerada segura e viavel para a avaliacao de areas corticais envolvidas na degluticao. Entretanto, os relatos de utilizacao de ressonâcia magnetica funcional diferiram entre os estudos revisados e houve variabilidade na metodologia utilizada, dificultando as comparacoes.