Cineradiography in Research and Clinical Studies of the Velopharyngeal Mechanism

Abstract

Within the past decade, cineradiographic procedures have come into wide use in research investigations of the velopharyngeal mechanism and in the clinical diagnosis of velopharyngeal inadequacy (2—6). During this period, instrumentation and techniques have been constantly improved in order to obtain films with better structural definition and at higher film rates. The considerations involved in obtaining films of good quality have been covered by the previous speakers; however, there are other methodological issues besides those already discussed which also should be considered. Today, I wish to direct my remarks to some of these other considerations and to point up some of the basic philosophies and principles which would appear to be of prime importance in the efficient utilization of cineradiography for the study of velopharyngeal function. Research versus Clinical Purposes For the purposes of this discussion, it will be helpful to make a distinction between the use of cineradiography for research and its use in clinical diagnosis of velopharyngeal incompetence. Although it is recognized that research and clinical diagnosis have some aspects in common, the distinction is being made to emphasize the fact that these two activities are basically different. The most obvious difference is that research must involve observations of more than one subject to be meaningful , whereas clinical diagnosis is restricted to observation of one patient. The basic purpose of research is to answer variants of the question: In general, how does the velopharyngeal mechanism operate? There may be almost an infinite number of answers to this question depending on the conditions under which the observations are made. The end result is a description of the operation of the mechanism. On the other hand, the basic question posed in clinical evaluations is: Does this individual possess the potential to achieve adequate velopharyngeal closure for