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[DYSPHAGIA] Velopharyngeal insufficiency testing
- Subject: [DYSPHAGIA] Velopharyngeal insufficiency testing
- From: kbreese@stny.rr.com (kbreese)
- Date: Tue, 13 Nov 2001 08:04:36 -0500
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----- Original Message -----=20
From: kbreese=20
To: Kate Farabaugh=20
Sent: Monday, November 12, 2001 9:59 PM
Subject: Re: [DYSPHAGIA] Velopharyngeal insufficiency testing
Kate -=20
It is indeed helpful to have both nasopharyngoscopic and multiview =
videofluoroscopic procedures to assess VP functioning. Cleft Palate =
Speech Management: A Multidisciplinary Approach by R. Shprintzen and J. =
Bardach (Mosby, 1995) has a good section on this. They state that "a =
transverse (axial) perspective on the velopharyngeal valve shows that =
the velum does not fill the entire pharyngeal volume.. the pharyngeal =
walls extend laterally beyond the outmost edges of the velum so that =
some degree of lateral pharyngeal wall motion is necessary if the vp =
valve is to be closed completely.... If only a lateral view =
videofluoroscopy were used to assess vp function, the insufficiency =
could not be seen or diagnosed because the lateral pharygeal walls =
cannot be seen in lateral view. Therfore it is possible for a lateral =
view radiograph to show what appears to be velopharygeal closure even =
though velophayngeal insufficiency is occurring." They go on to explain =
that because surgery may depend on the diagnostic information obtained, =
that false positives and false negatives should not be tolerated. They =
recommend both procedures. They have many studies referenced in this =
chapter. Here are a few:
Croft CB, etal "Patterns of velopharyngeal valving in normal and cleft =
palate subjects: a multiview videofluoroscopic and nasendoscopic sudy." =
Laryngoscope, 91:265-271, 1981b
Shprintzen, etal, "Evaluation of velopharyngeal insufficiency", =
Otolaryngol Clin N Am 22:519-536, 1989.
Siegel-Sadewitz, etal, "Nasopharyngoscopy of the normal velopharyngeal =
sphincter: an experiment of biofeedback", Cleft Palate J 19: 194-201, =
1982
Hope that helps! I love Shprintzen's book. It's been very helpful to =
me with this population.
Kathy
----- Original Message -----=20
From: "Kate Farabaugh" <Kate.Farabaugh@BannerHealth.com>
To: <dysphagia@medonline.com>
Sent: Monday, November 12, 2001 5:54 PM
Subject: [DYSPHAGIA] Velopharyngeal insufficiency testing
> I am posting this for one of my staff and the questions is VPI =
related and not swallowing although it involves FEES.
> One of our pediatricians wanted to know if there was any research =
out there on the efficacy or benefit of using endoscopy vs =
cineflourography to assess VP function. Some of our patients travel to a =
larger city where there is a children's hospital and are returning with =
endoscopy (FEES) reports to assess VPI and he needs reassurance this is =
sufficient. I can speak to him from what I as a FEES therapist know and =
what I see but this is a person best served by reading a study..... Any =
one have any references out there?=20
> Thanks
>=20
> Kate Farabaugh, MA, CCC-SLP
> Pediatric Rehab Manager=20
> 970.350.6155
> kate.farabaugh@bannerhealth.com
>=20
> =
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> To UNSUBSCRIBE from this list, please send an e-mail message to
> majordomo@medonline.com with the following text as a message:
> unsubscribe dysphagia
> =
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>=20
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<DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
<DIV=20
style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
<A href=3D"mailto:kbreese@stny.rr.com"; =
title=3Dkbreese@stny.rr.com>kbreese</A>=20
</DIV>
<DIV style=3D"FONT: 10pt arial"><B>To:</B> <A=20
href=3D"mailto:Kate.Farabaugh@BannerHealth.com"=20
title=3DKate.Farabaugh@BannerHealth.com>Kate Farabaugh</A> </DIV>
<DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Monday, November 12, 2001 =
9:59=20
PM</DIV>
<DIV style=3D"FONT: 10pt arial"><B>Subject:</B> Re: [DYSPHAGIA] =
Velopharyngeal=20
insufficiency testing</DIV>
<DIV><BR></DIV>
<DIV><FONT face=3DArial size=3D2>Kate - </FONT></DIV>
<DIV> </DIV>
<DIV><FONT face=3DArial size=3D2>It is indeed helpful to have both=20
nasopharyngoscopic and multiview videofluoroscopic procedures to =
assess VP=20
functioning. </FONT><U>Cleft Palate Speech Management: A=20
Multidisciplinary Approach</U> by R. Shprintzen and J. Bardach (Mosby, =
1995)=20
has a good section on this. They state that "a transverse =
(axial)=20
perspective on the velopharyngeal valve shows that the velum does not =
fill the=20
entire pharyngeal volume.. the pharyngeal walls extend laterally =
beyond=20
the outmost edges of the velum so that some degree of lateral =
pharyngeal wall=20
motion is necessary if the vp valve is to be closed =
completely.... If=20
only a lateral view videofluoroscopy were used to assess vp function, =
the=20
insufficiency could not be seen or diagnosed because the lateral =
pharygeal=20
walls cannot be seen in lateral view. Therfore it is possible =
for a=20
lateral view radiograph to show what appears to be velopharygeal =
closure even=20
though velophayngeal insufficiency is occurring." They go on to =
explain=20
that because surgery may depend on the diagnostic information =
obtained, that=20
false positives and false negatives should not be tolerated. =
They=20
recommend both procedures. They have many studies referenced in =
this=20
chapter. Here are a few:</DIV>
<DIV> </DIV>
<DIV>Croft CB, etal "Patterns of velopharyngeal valving in normal and =
cleft=20
palate subjects: a multiview videofluoroscopic and nasendoscopic =
sudy." =20
Laryngoscope, 91:265-271, 1981b</DIV>
<DIV> </DIV>
<DIV>Shprintzen, etal, "Evaluation of velopharyngeal insufficiency",=20
Otolaryngol Clin N Am 22:519-536, 1989.</DIV>
<DIV> </DIV>
<DIV>Siegel-Sadewitz, etal, "Nasopharyngoscopy of the normal =
velopharyngeal=20
sphincter: an experiment of biofeedback", Cleft Palate J 19: 194-201,=20
1982</DIV>
<DIV> </DIV>
<DIV>Hope that helps! I love Shprintzen's book. It's =
been=20
very helpful to me with this population.</DIV>
<DIV> </DIV>
<DIV>Kathy</DIV>
<DIV> </DIV>
<DIV> </DIV>
<DIV><FONT face=3DArial size=3D2>----- Original Message ----- </FONT>
<DIV><FONT face=3DArial size=3D2>From: "Kate Farabaugh" <</FONT><A=20
href=3D"mailto:Kate.Farabaugh@BannerHealth.com";><FONT face=3DArial=20
size=3D2>Kate.Farabaugh@BannerHealth.com</FONT></A><FONT face=3DArial=20
size=3D2>></FONT></DIV>
<DIV><FONT face=3DArial size=3D2>To: <</FONT><A=20
href=3D"mailto:dysphagia@medonline.com";><FONT face=3DArial=20
size=3D2>dysphagia@medonline.com</FONT></A><FONT face=3DArial=20
size=3D2>></FONT></DIV>
<DIV><FONT face=3DArial size=3D2>Sent: Monday, November 12, 2001 5:54=20
PM</FONT></DIV>
<DIV><FONT face=3DArial size=3D2>Subject: [DYSPHAGIA] Velopharyngeal =
insufficiency=20
testing</FONT></DIV></DIV>
<DIV><BR></DIV><FONT face=3DArial size=3D2>> I am posting this for =
one of my=20
staff and the questions is VPI related and not swallowing although it =
involves=20
FEES.<BR>> One of our pediatricians wanted to know if there was any =
research out there on the efficacy or benefit of using endoscopy vs=20
cineflourography to assess VP function. Some of our patients travel to =
a=20
larger city where there is a children's hospital and are returning =
with=20
endoscopy (FEES) reports to assess VPI and he needs reassurance this =
is=20
sufficient. I can speak to him from what I as a FEES therapist know =
and what I=20
see but this is a person best served by reading a study..... Any one =
have any=20
references out there? <BR>> Thanks<BR>> <BR>> Kate Farabaugh, =
MA,=20
CCC-SLP<BR>> Pediatric Rehab Manager <BR>> 970.350.6155<BR>>=20
</FONT><A href=3D"mailto:kate.farabaugh@bannerhealth.com";><FONT =
face=3DArial=20
size=3D2>kate.farabaugh@bannerhealth.com</FONT></A><BR><FONT =
face=3DArial=20
size=3D2>> <BR>>=20
=
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To UNSUBSCRIBE from this list, please send an e-mail message =
to<BR>>=20
</FONT><A href=3D"mailto:majordomo@medonline.com";><FONT face=3DArial=20
size=3D2>majordomo@medonline.com</FONT></A><FONT face=3DArial =
size=3D2> with the=20
following text as a message:<BR>> unsubscribe dysphagia<BR>>=20
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>=20
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