Comparison Of Velopharyngeal Closure Between Non-verbal And Verbal State: A Combination Of Cephalometric And Velopharyngeal Endoscopy Investigation

Objective:To compare the velopharyngeal closure during verbal state(take /i/ for an example)and non-verbal state(take blowing exercise for an example).Method:Firstly,we compared the lifting distance of soft palate in the sagittal plane of 19 typical Mandarin adult speakers by lateral cephalic film during different subtypes of blowing activities.Then we compared the rate of velopharyngeal incompetence(RVPI)in the cross-section by nasopharyngeal endoscopy for a group of 26 typical adult subjects during vowel /i/ and blowing activity.Result:The blowing activity could be classified into three different states: simple blowing cheek state,deep blowing cheek state and air blowing state.Data of lifting height of soft palate by lateral cephalic film and RVPI by nasopharyngeal endoscopy showed that there were significant differences among the four states of investigation,such as articulation state,simple blowing cheek state,deep blowing cheek state and air blowing state.Post-hoc analysis indicated that there was significant difference between each two of the four states,except the articulation state with air blowing state.The RVPI was largest for the simple cheek blowing state,followed by deep cheek blowing state.The RVPI of the air blowing state and the articulation state were very small,which indicated that the velopharyngeal closure was almost complete for these two.Conclusion: The velopharyngeal closure showed a large variability during the blowing activity.The common instruction of blowing resulted into two different states: simple blowing cheek state and deep blowing cheek state.The velopharyngeal closure in both of the two types of blowing were not comparable to air blowing state and articulation state.The movement of velopharyngeal closure and RVPI were quite similar,which indicated the air blowing state can play the maximum function of the velopharyngeal closure as articulation.The finding indicated that the air-blowing may be used to strengthen velopharyngeal closure function for better speech function.The velopharyngeal closure during non-verbal activities and verbal activity on cleft speakers merits further exploration.