Chapter Sixteen Flashcards
Chapter 16
Videofluoroscopy
xxx
Imaging of the Velopharyngeal Valve
Imaging of the velopharyngeal valve is indicated to determine…
It is important to obtain this information so that
the cause, approximate size, and particularly the location of the velopharyngeal opening.
the best form of surgical intervention can be determined.
History of Radiography for VPI
Radiography—
History of radiography for evaluation of VPI:
1.
2.
3.
use of the roentgen ray (X-ray) to image internal body parts
- Lateral cephalometric X-rays
- Cineradiography
- Videofluoroscopy
Lateral Cephalometric X-rays
Lateral cephalometric X-ray (also called a lateral “ceph”) —
still radiographic images of the midsagittal plane of the head, showing the velum and posterior pharyngeal wall
Lateral Cephalometric X-rays
Taken during__________
Shows: 1. 2. 3. 4. 5.
phoneme prolongation
Hard palate
Velum at rest
Velar length and height during phonation
Posterior pharyngeal wall
Cervical spine and cranial base abnormalities that can affect position of the posterior pharyngeal wall
Disadvantages of LateralCeph X-rays
- A lateral ceph X-ray shows on the ______.
- It cannot see _______
- It’s a _____only.
a. Speech is dynamic, but X-ray can show _______ - Image is ______
a..
b.
midsagittal plane
lateral pharyngeal walls.
still picture
only structure, not function.
summation of all parts.
a. Beam travels through all tissues
b. Small or unilateral openings do not show.
Cineradiography
Cineradiography (also called cine study)—
a series of 16 to 24 frames of radiographs per second, which were recorded on motion picture film; incorporated several views so examiner could appreciate all aspects of the valve
Disadvantages of Cineradiography:
1.
2.
No way to simultaneously record sound
Relatively high radiation dosage
Videofluoroscopy—
Videofluoroscopic speech study—
an imaging technique used to obtain real-time moving images of internal structures; done through the use of a fluoroscope.
moving images of the velopharyngeal valve, along with simultaneous audio recordings, for the evaluation of velopharyngeal function during speech
Videofluoroscopy
__________assessment
Can see…
Allows…
Multiview radiographic
all structures of the VP valve in order to evaluate function during speech
simultaneous audio and video recording
Videofluoroscopy can be used to: 1. 2. 3. 4. 5.
Confirm the presence of a velopharyngeal opening and estimate the size.
Differentiate the cause of velopharyngeal dysfunction (e.g., a short velum versus poor velar movement).
Show the vertical movement of the velum during speech.
Provide a view of the entire length of the posterior pharyngeal wall.
Evaluate the effects of some surgical procedures.
Purpose of Multiple Views
Velopharyngeal port is…
Necessary to…
Most common views are as follows:
three-dimensional structure but fluoroscopic imaging is only two-dimensional
obtain three mutually perpendicular planes to fully evaluate all sides of the velopharyngeal port
- Lateral projection
- Frontal or anterior-posterior (AP) projection
- Base projection
Lateral View
Beam…
Shows…
Illustrates effective ______, _______, and ________, _______wall, _____movement, and patency of a _____when barium is in the nasal cavity.
enters side of the head
the velum and posterior pharyngeal wall in a midsagittal plane.
length of the velum; velar movement; height of the velum during speech
posterior pharyngeal; tongue; fistula
Lateral View
Position:
Patient sits upright or lays on the side.
Frontal (Also Called Anterior-Posterior, or AP) View
Beam…
The AP view shows…
Position:
enters the front of the nose.
the lateral pharyngeal walls at rest and during speech.
Patient sits upright or lays in a supine position.