Selective Movement of the Lateral Aspects of the Pharyngeal Walls during Velopharyngeal Closure for Speech, Blowing, and Whilstling in Normals

Abstract

In a study of five normal adult subjects performing speech, blowing, whistling, swallowing, and gagging tasks in both frontal and lateral cine-fluorographic projections, Shprintzen, et al. (6') found evidence of two different velopharyngeal closure mechanisms, and possibly a third. Speech, blowing, and whistling were found to share a common closure mechanism (labelled the pneumatic closure mechanism) which involved a characteristic velar height and configuration of the lateral aspects of the pharyngeal walls (LAPW). No approximation of the LAPW was evident in any of the five subjects during the pneumatic activities. Gagging and dry swallowing were found to share a common closure mechanism (labelled the nonpneumatic closure mechanism) which showed a greater velar height and total or near total LAPW approximation in all five subjects. Reflexive swallowing also showed LAPW approximation, but the degree of medial movement of the LAPW and velar elevations was less than that for the dry swallow. Other investigators (I , 3) have also noted differences between types of velopha— ryngeal closure for various activities. The question arises as to the basis of these different patterns of velopharyngeal closure. Shprintzen, et al. (6) found that the general LAPW configuration as Dr. Robert J. Shprintzen is Coordinator