关键词: 腭咽闭合, 主观判听, 客观评估, 鼻咽纤维镜

Abstract:

Objective To investigate the application of the perceptual assessment in the diagnosis of the velopharyngeal
function, to provide a reference to the improvement of the velopharyngeal function diagnosis through comparing
the consistency between the diagnosis of the perceptual assessment and the objective assessment. Methods All subjects（
254） were selected from the Department of Cleft Lip and Palate Surgery, West China School of Stomatology,
Sichuan University, from 2000—2010. The results of the perceptual and the nasopharyngeal fiberscope（NPF） assessment were retrospectively analyzed, and the consistent rate between the two assessment methods was calculated. The Kappa test and the correlation analysis were performed to analyze the consistency and correlation, and the factors relating to the perceptual assessment were analyzed by the correlation coefficient. Results There were 254 patients met the inclusion criteria. The consistent number of the patients diagnosed by the perceptual and the objective assessment as velopharyngeal competence（VPC） and velopharyngeal insufficiency（VPI） were 58 and 167 respectively. The consistent rate was 88.58% for all patients, and 66.67% for the VPC patients. The Kappa value was 0.721, Spearman’s R=0.751, P＜0.05. There were correlation between the hypernasality, the nasal emission and the subjective assessment, and Spearman’s R=0.697, 0.590, P＜0.05. Conclusion The VPC patients and the VPI patients with moderate and severe hypernasality and nasal emission diagnosed by the perceptual assessment could be exempt from the objective examination. Patients diagnosed with mild hypernasality and nasal emission by the perceptual assessment should be further referred to NPF or other instruments.

Key words: velopharyngeal closure, perceptual assessment, objective assessment, nasopharyngeal fiberscope