Screening of velopharyngeal closure based on nasal airflow rate measurements.

Although sophisticated techniques for estimating velopharyngeal port area during speech are available, clinicians continue to seek approaches for screening patients with suspected velar inadequacy. The aim of the present study is to determine the sensitivity and specificity of predicting velopharyngeal dysfunction based on nasal airflow measurements. The pressure-flow technique was used to measure velopharyngeal orifice area and nasal airflow rate in 211 subjects with cleft palate or velar dysfunction, or both. The data demonstrate that nasal airflow rates above 125 cc/sec are almost always associated with velar dysfunction. Sensitivity and specificity of this index were high (0.85 and 0.96, respectively). A correct diagnosis was made in 93% of the cases. As expected, errors in judgment occurred most frequently in subjects with borderline velopharyngeal inadequacy.