Intraindividual change in the occurrence of Passavant's ridge due to change in velopharyngeal sphincter function: a videofluoroscopic study.

Passavant's ridge was studied by means of videofluoroscopy and nasopharyngoscopy in 80 patients with hypernasal speech. In patients with Passavant's ridge an improvement of the sphincter function was found to be associated with an enlargement of the ridge. It was also observed that the ridge could disappear if complete velopharyngeal closure was achieved without surgical intervention of the ridge area. The results indicate that Passavant's ridge is of compensatory origin.

Velopharyngeal movement patterns in patients alternating between oral and glottal articulation: a clinical and cineradiographical study.

Eight patients who presented velopharyngeal incompetence and who spontaneously alternated between oral and glottal stop articulation were cineradiographically examined in lateral and frontal projections to compare their oral stops and glottal stop substitutions. A cineradiographic frame-by-frame analysis of the movements of the velum and the lateral and posterior pharyngeal walls was performed. During glottal stop substitutions and coarticulation involving glottal stops and oral lingual or bilabial stop gestures, all patients demonstrated either no velopharyngeal movement or impaired movement, mostly affecting the lateral pharyngeal walls. In contrast, during oral stops, moderate-to-good velopharyngeal movements were produced. Poor quality or absence of velopharyngeal movement associated with glottal stop substitutions may be misinterpreted as weakness or inability to perform motor activity. Presurgical cineradiographic or fluoroscopic analysis of a patient's speech with regard to velopharyngeal movements should therefore be based on speech sequences free from glottal stop substitutions. A careful speech analysis should also precede presurgical cineradiography.