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the_role_of_nasofiberscopic_nsf_visualization_in_the_assessment_and_management_of_resonance_disorders_in_cleft_palate_patients [2014/03/25 10:18] (current)
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 +Maria A. Hortis-Dzierzbicka (Poland)
 +**The role of nasofiberscopic (NSF) visualization in the assessment and management of resonance disorders in cleft palate patients**
 +Department of Otolaryngology and Maxillofacial Surgery, University of Warmia and Mazury in Olsztyn.
 +Cleft lip and/or palate (CLP) is the most frequent developmental craniofacial defect causative of velopharyngeal insufficiency (VPI) and hypernasality in about 25-30% of the cases, despite primary palatal closure. To improve diagnostics of the causation beyond the basic speech evaluation by an experienced speech pathologist, we advocate the nasofiberoscopy, i.e. upper airway flexible endoscopy. In fact we believe that using flexible optics, is irreplaceable in the diagnosis of CLP speech deficits. Nasofiberoscopy (NFS) enables a direct visualization of the velopharyngeal sphincter at rest and during speech, allowing the assessment of its structure, function and resonance characteristics. Efficiency of the speech apparatus after palatal reconstruction in CP children is determined not only by the velopharyngeal sphincter function and palatal integrity, but also by the patency of the nasal passages, tonsillar and adenoid hypertrophy, state of the larynx, and the correct ventilation of the middle ear by correctly functioning the Eustachian tubes. For this reason a NSF evaluation of the entire vocal tract in CP children presenting with secondary resonance disorders is of paramount significance for selection of proper treatment procedures in this patient population. 
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