BACKGROUND Nasopharyngoscopy is a common method to evaluate velopharyngeal closure in patients with cleft palate. However, insertion of a fiberoptic nasopharyngoscope causes discomfort in patients. The aim of this study was to estimate the reliability of short-time exposure images obtained using 320-row area detector computed tomography (320-ADCT) as a novel evaluation method for the assessment of velopharyngeal function. METHODS We evaluated five healthy adult volunteers and five postoperative adult patients with cleft palate. During a 3.3-s imaging exposure, the participants were asked to perform two tasks: nasal inspiration and subsequent oral expiration through a catheter into a water-filled cup. The movement of the velopharyngeal structures was recorded during each examination, and the presence of velopharyngeal insufficiency (VPI) and velopharyngeal closure (VPC) patterns were estimated. If VPI was detected, the cross-sectional area was also calculated. Cohen's kappa and weighted kappa coefficients were used to evaluate the concordance of nasopharyngoscopy and 320-ADCT evaluation. RESULTS Speech pathology evaluation did not reveal hypernasality in any study participant. Micro-VPI was detected by nasopharyngoscopy in one healthy volunteer and two patients. 320-ADCT detected micro-VPI in two more patients. The cross-sectional area of the VPI in these subjects ranged from 2.53 to 16.28 mm2. Nasopharyngoscopy and 320-ADCT were concordant in detecting VPI in eight participants (κ = 0.6) and in assessing VPC patterns in nine (κ = 0.82). Moreover, images obtained using 320-ADCT allowed for reduced dead angle and, thus, easy detection of micro-VPI and Passavant's ridges. CONCLUSION Although the radiation exposure cannot be ignored, our novel evaluation method using 320-ADCT enables more detailed evaluation of VPC than nasopharyngoscopy. Future studies should investigate the relationship between 320-ADCT findings and speech pathology evaluations.

中文翻译：

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使用四维计算机体层摄影术进行的咽喉闭合分析：健康志愿者和volunteer裂成年患者的初步研究。

背景技术鼻咽镜检查是评估evaluate裂患者咽喉闭合的常用方法。但是，插入纤维鼻咽镜会引起患者不适。这项研究的目的是评估使用320行面积检测器计算机断层扫描（320-ADCT）作为评估咽喉功能的一种新颖评估方法获得的短时曝光图像的可靠性。方法我们评估了五名健康的成人志愿者和五名术后成人的c裂患者。在3.3秒的成像曝光期间，要求参与者执行两项任务：吸鼻和随后通过导管进入盛满水的杯子进行口腔呼气。每次检查时记录下咽喉结构的运动，并评估了咽咽功能不全（VPI）和咽咽闭合（VPC）模式的存在。如果检测到VPI，则还要计算横截面积。使用科恩卡伯系数和加权卡伯系数来评估鼻咽镜和320-ADCT评估的一致性。结果言语病理学评估未发现任何研究参与者有鼻音过高。通过鼻咽镜检查在一名健康志愿者和两名患者中检测到了微VPI。320-ADCT在另外两名患者中检测到微VPI。在这些受试者中，VPI的横截面积为2.53至16.28 mm2。鼻咽镜检查和320-ADCT在检测八名参与者（κ= 0.6）的VPI和评估九名参与者（κ= 0.82）的VPC模式方面是一致的。此外，使用320-ADCT获得的图像可减少死角，因此，易于检测微型VPI和Passavant的山脊。结论尽管不能忽略辐射暴露，但我们新颖的使用320-ADCT的评估方法比鼻咽镜检查能够更详细地评估VPC。未来的研究应调查320-ADCT结果与言语病理学评估之间的关系。