Comparative reliability of nasal pharyngoscopy and videofluorography in the assessment of velopharyngeal incompetence.

A panel of three has reviewed a series of 100 videotape records of nasopharyngoscopy, basal fluorography and lateral fluorography made of patients being investigated for velopharyngeal incompetence. The quality of each record was assessed and estimates of movement made as a basis for comparison of the three methods. Nasopharyngoscopy and lateral fluorography provide a high proportion of material with good definition of the velopharyngeal isthmus (80%). Basal fluorography is less reliable (60%). Lateral fluorography was found to be unreliable as a measure of velopharyngeal incompetence, while estimates of movement from the other two were compatible. Basal fluorography is the procedure of choice in young children. Nasendoscopy provides good quality information more often than basal fluorography in patients over the age of eight and is markedly superior in the presence of a pharyngeal flap.