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Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate

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 32...

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Autores principales: Kobayashi, Yoshikazu, Kanamori, Daisuke, Fujii, Naoko, Kataoka, Yumi, Hirai, Emiko, Yoshioka, Satoshi, Satoh, Koji, Toyama, Hiroshi, Naito, Kensei, Matsuo, Koichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613253/
https://www.ncbi.nlm.nih.gov/pubmed/31286915
http://dx.doi.org/10.1186/s12880-019-0350-4
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author Kobayashi, Yoshikazu
Kanamori, Daisuke
Fujii, Naoko
Kataoka, Yumi
Hirai, Emiko
Yoshioka, Satoshi
Satoh, Koji
Toyama, Hiroshi
Naito, Kensei
Matsuo, Koichiro
author_facet Kobayashi, Yoshikazu
Kanamori, Daisuke
Fujii, Naoko
Kataoka, Yumi
Hirai, Emiko
Yoshioka, Satoshi
Satoh, Koji
Toyama, Hiroshi
Naito, Kensei
Matsuo, Koichiro
author_sort Kobayashi, Yoshikazu
collection PubMed
description 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 mm(2). 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12880-019-0350-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-66132532019-07-17 Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate Kobayashi, Yoshikazu Kanamori, Daisuke Fujii, Naoko Kataoka, Yumi Hirai, Emiko Yoshioka, Satoshi Satoh, Koji Toyama, Hiroshi Naito, Kensei Matsuo, Koichiro BMC Med Imaging Research Article 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 mm(2). 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12880-019-0350-4) contains supplementary material, which is available to authorized users. BioMed Central 2019-07-08 /pmc/articles/PMC6613253/ /pubmed/31286915 http://dx.doi.org/10.1186/s12880-019-0350-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kobayashi, Yoshikazu
Kanamori, Daisuke
Fujii, Naoko
Kataoka, Yumi
Hirai, Emiko
Yoshioka, Satoshi
Satoh, Koji
Toyama, Hiroshi
Naito, Kensei
Matsuo, Koichiro
Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate
title Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate
title_full Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate
title_fullStr Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate
title_full_unstemmed Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate
title_short Velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate
title_sort velopharyngeal closure analysis using four-dimensional computed tomography: a pilot study of healthy volunteers and adult patients with cleft palate
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613253/
https://www.ncbi.nlm.nih.gov/pubmed/31286915
http://dx.doi.org/10.1186/s12880-019-0350-4
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