Background: Velopharyngeal Insufficiency (VPI) is the most common seen disorder in children with associated craniofacial developmental anomalies of which cleft palate is the most common. Overt cleft palate, in both before and after repair, is by far the most common cause of VPI. Computerized tomography (CT scan) is used to assess mobility of the velum, lateral and posterior pharyngeal walls, but it needs a cooperative patient (>5years). Its advantages are the easy definition of measured parameters, the provision of automated numerical value regarding the size of velopharyngeal gap and the amount of displacement of each wall as well as the provision information about the vertical level of closure of the velopharyngeal port referring to surrounding structures.
Aim of the work: To analyze the CT findings and its correlation to severity of the hypernasality in velopharyngeal insufficiency patients.
patients and methods: This study was applied on 50 patients with age ranging from 20 - 60 years, from January 2017 to December 2020, diagnosed hypernasality caused by velopharyngeal insufficiency, from the outpatient Phoniatric clinic at Ain Shams University Hospitals. Each patient was subjected to the following:1- Auditory perceptual assessment (APA) to assess hypernasality presence and degrees. 2-Computrixed tomography (facial view) over the velopharyngeal valve to assess the valvular functions. To compare CT findings of the velopharyngeal port to the severity of the hypernasality in patients.
Results: It showed that mild degree hyper-nasality will be seen in CT as valve gap (while sustained vowel production) with mean of 1.914 mm gap ranging from (0.03 -5.23 mm) in 17 cases. While moderate degree hyper-nasality showed CT valve gap with mean of 5.75 range from (2.05-10 mm) in 16 cases. Moderately severe hyper nasality showed CT valve gap with mean of 7.09 range valve gap (3.45-11mm) in 12 cases. Severe degree hyper-nasality showed CT valve gap mean of 10.42 ranges from (7.05-13 mm) in 5 cases. The overlapping between ranges in different degrees of nasality was obvious
Conclusion: The present study showed that CT scan measurement suggestive of severity in moderate to severe degrees of hypernasality more than mild and mild to moderate degrees.