الفهرس 
Anatomy of the Velopharyngeal PortOnly 14 pages are availabe for public view
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Abstract
Velopharyngeal closure is critical for production of vowels and oral consonants so, has a profound impact on speech intelligibility.
The velopharyngeal port is bounded anteriorly by the soft palate (velum), laterally by the lateral pharyngeal walls, and posteriorly by the posterior pharyngeal wall. Closure of the velopharynx during speech is a voluntary action that is mediated by the motor cortex and that requires the coordinated action of the velopharyngeal musculature.
The soft palate includes five main muscles that arise in pairs, one on either side of the midline of the soft palate. The soft palate elevators are the LVP and musculus uvulae. The two depressors are the palatopharyngeus and palatoglossus and the TVP is the tensor muscle acting on the soft palate apparatus. There are two other pharyngeal muscles that also arise in pairs and assist in the functional mechanism of velopharyngeal closure, they are the superior pharyngeal constrictor and the salpingopharyngeus muscles.
Normal individuals used variable degrees of posterior movement of the velum, lateral pharyngeal wall motion toward the midline and posterior pharyngeal wall motion. The variations in the contribution of each of these components produce the several patterns of velopharyngeal closure. There are four main types of closure patterns. The variability of the closure depends on the activity performed wether in pneumatic activities (blowing, speaking, and whistling) or non pneumatic activities (swallowing, suction and vomiting reflex).
It is obvious that diagnostic accuracy is critical to consistently good treatment outcomes. Various mechanical devices have been developed to assess and measure the velopharyngeal port. This study aimed to assess the velopharyngeal pattern of closure using flexible nasoendoscopy.
This study included one hundred normal subjects, each were subjected to the protocol of assessment that is applied in Phoniatric unit, Ain Shams University. This study aimed to identify the variable patterns of closure of velopharyngeal valve (VPV) in normal subjects in order to further understand the nature of VPV closure and generalize information for future researches. The study concluded, coronal pattern as the most common pattern of closure VPV regardless the gender.
Nasoendoscopy allows direct observation of the anatomy and the dynamic activity of the velopharyngeal sphincter and also allows the patient to observe his own velar function, so it can be used as a therapeutic tool during speech therapy as the patient can control the desired action visually. However, the complete visualization of the velopharyngeal orifice by using the nasoendoscopy was not possible in some cases, owing to the dead angle created by the elevated velum in the cases with good velar movement. Assesment of the velopharngeal function through nasoendoscopy is a reasonably valid technique, though it lacks definitive quantitative measurements. Therefore, it was recommended that the VPV should be examined by both nasoendoscopy and videofluoroscopy. Using the two procedures together overcome the weakness of each, and at the same time enhances the strengths of both.