ASSESSMENT OF THE VELOPHARYNGEAL SPHINCTER AND ITS ROLE IN THE SPEECH OF PATIENTS WITH CLEFT LIP AND PALATE
Journal
Physioacta
Date Issued
2016
Author(s)
Gjorgova J
Popovski V
Abstract
The cleft lip and palate are congenital anomalies with different dimensions; their
existence alters the facial aesthetics and many orofacial functions as well. They
characterize with a discontinuity of the lip, hard and soft palate and the alveolar ridge.
The gravity of the clinical picture can be detennined by the lack of continuity in the skin
tissue, muscles and bones, which can be manifested with a mild form of lip distortion,
severe bilateral cleft lip, palate, and alveolar bone and the most severe - oblique facial
cleft. The clefts can be of different dimensions; still, regardless of the size, the
articulatory speech is rendered more difficult due to the constant communication
between the oral and nasal cavity. Every child born with a cleft palate has dysfunction
of the velopharyngeal sphincter leading to pathology of the verbal communication.
The velopharyngeal sphincter is a tridimensional muscle area between the oral and nasal
cavity. It is built by the lateral and posterior pharyngeal wall and the soft palate. The
role of the velopharyngeal sphincter is to separate the oral from the nasal cavity, and, in
that way, enable normal speech and swallowing, that is, prevent the air from escaping
through the nose instead of the mouth.
The speech of children with cleft is usually accompanied by a nasal sound that is
associated with the velopharyngeal insufficiency (weak function of the soft palate).
When the soft palate does not close completely the airflow through the nose, air passes
through the thin passage and nasal speech is heard. Today, one of the techniques used to
assess the articulatory function of the oropharyngeal region, both in normal and
pathological cases, is the magnetic resonance. Compared to other techniques, it has
more advantages due to its non-invasiveness, non-radioactivity and the fact that it is
video fluoroscopic. It is used for obtaining dynamic pictures while in motion, the so
called, magnetic resonance imaging.
existence alters the facial aesthetics and many orofacial functions as well. They
characterize with a discontinuity of the lip, hard and soft palate and the alveolar ridge.
The gravity of the clinical picture can be detennined by the lack of continuity in the skin
tissue, muscles and bones, which can be manifested with a mild form of lip distortion,
severe bilateral cleft lip, palate, and alveolar bone and the most severe - oblique facial
cleft. The clefts can be of different dimensions; still, regardless of the size, the
articulatory speech is rendered more difficult due to the constant communication
between the oral and nasal cavity. Every child born with a cleft palate has dysfunction
of the velopharyngeal sphincter leading to pathology of the verbal communication.
The velopharyngeal sphincter is a tridimensional muscle area between the oral and nasal
cavity. It is built by the lateral and posterior pharyngeal wall and the soft palate. The
role of the velopharyngeal sphincter is to separate the oral from the nasal cavity, and, in
that way, enable normal speech and swallowing, that is, prevent the air from escaping
through the nose instead of the mouth.
The speech of children with cleft is usually accompanied by a nasal sound that is
associated with the velopharyngeal insufficiency (weak function of the soft palate).
When the soft palate does not close completely the airflow through the nose, air passes
through the thin passage and nasal speech is heard. Today, one of the techniques used to
assess the articulatory function of the oropharyngeal region, both in normal and
pathological cases, is the magnetic resonance. Compared to other techniques, it has
more advantages due to its non-invasiveness, non-radioactivity and the fact that it is
video fluoroscopic. It is used for obtaining dynamic pictures while in motion, the so
called, magnetic resonance imaging.
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