Practical application of flexible fiberoptic nasopharyngoscopy for evaluating velopharyngeal function.

Flexible fiberoptic nasopharyngoscopy increasingly is recognized as a valuable tool for assessing velopharyngeal function. There are, however, few reports in the literature describing a method for routine use of nasoendoscopy, the outcome of such evaluations, the criteria for referral, and a mechanism for communicating findings. Results from a 2-year clinical nasoendoscopy data base are presented. Ninety-eight patients were referred for evaluation of velopharyngeal function during speech. Flexible fiberoptic nasopharyngoscopic evaluations were conducted in 85 patients. Patients ranged in age from 3 years to adult. Eighty-nine percent of the evaluations were completed successfully on a first attempt. A standard format has been designed to communicate the results of nasoendoscopic examinations to primary and tertiary care providers. Nasoendoscopy has become an integral part of our cleft team care and is used routinely for decisions regarding palatal management, fabrication and fitting of palatal prostheses, and treatment of resonance disorders following pharyngeal flap surgery.