The preferred method of evaluation was video fluoroscopy
(57.7%), and less commonly with barium swallow (22.3%) or with clinical symptoms alone (0.1%).
They used video fluoroscopy
to evaluate swallowing.
Presently the gold standard for assessment of velopharyngeal incompetence is "direct visualization" procedures like multi-view video fluoroscopy and nasopahryngoscopy.
Nasopharyngoscopy equipment is not available with us and we do not have trained personnel for conventional multi-view video fluoroscopy; hence we have adopted Digital subtraction angiography equipment for documentation of the velopharyngeal movements without simultaneous audio recording and used the findings for clinical correlation.
In 1969 two new procedures for direct visualization of the velopharyngeal valve were introduced; the multi-view video fluoroscopy (Skolnick) (7,8,9) and nasopharyngoscopy by (Pigott).
Speech language therapy for vent residents has been extensive, including, multiple bedside and in-house video fluoroscopy
swallowing evaluations (and preparation of related individualized diet consistencies), assistive devices ranging from low-tech communication boards to sophisticated laptop computer devices, and an array of tracheostomy "speaking" valves.
These measurements normally take place with concurrent video fluoroscopy
, and the workstation allows precise time alignment between the physiological measurements and video data.