Correlação entre os achados do teste de emissão de ar nasal e da nasofaringoscopia em pacientes com fissura labiopalatina operada Correlation between the findings on the nasal air emission test and nasopharyngoscopy in patients with operated cleft lip and palate

Abstract

OBJETIVO: Verificar se as informações colhidas no teste de emissão de ar nasal apresentam compatibilidade com os achados da nasofaringoscopia, podendo auxiliar no julgamento da funcionalidade do mecanismo velofaríngeo. MÉTODOS: Foram analisados os achados do teste de emissão de ar nasal e nasofaringoscopia em 21 indivíduos operados de fissura pós-forame e transforame incisivo, de ambos os gêneros, com idade superior a oito anos. A correlação foi feita observando se, diante de um gap velofaríngeo (espaço entre as estruturas da região velofaríngea) visualizado na nasofaringoscopia, notava-se embaçamento do espelho de Glatzel no teste de emissão de ar nasal. Os dados foram analisados estatisticamente pelo índice de Kappa. RESULTADOS: Notou-se concordância entre os testes (pOBJECTIVE: To verify whether the information collected in the nasal air emission test are compatible to the nasopharyngoscopy findings, helping the assessment of the velopharyngeal mechanism functionality. METHODS: The findings of nasal air emission test and nasopharyngoscopy were analyzed in 21 individuals of both genders, over the age of 8 years, operated for post-foramen and transincisive foramen fissure. The correlation was carried out observing whether or not, in the face of a velopharyngeal gap visualized in the nasopharyngoscopy, misting of the Glatzel mirror was noted in the nasal air emission test. Data were statistically analyzed using the Kappa index. RESULTS: An agreement was observed between the tests (p<0,05), and it was considered higher during blowing, emission of isolated stops and fricatives in words and phrases (Kappa: 0,897; 0,887; 0,774 and 0,774, respectively), than for emission of stops in words, isolated fricatives and stops in phrases (Kappa: 0,691; 0,640 and 0,488, respectively). Incompatibility occurred in a few cases, in the presence of a small gap, complete closing and complete closing with bubbling. Regarding the tendency of velopharyngeal closing, it was found a predominance of the coronal type (48%), and improvement was noted in 62% of the subjects with the use of therapeutic test. CONCLUSION: The validity of the nasal air emission test when compared with nasopharyngoscopy was observed. It is, however, important to emphasize that the nasal air emission test must be carefully applied and it shouldn't replace the nasopharyngoscopy, which is conclusive for surgical and therapeutic planning.

Keywords

• Fissura palatina
• Endoscopia
• Insuficiência velofaríngea
• Fonoterapia
• Cleft palate
• Endoscopy
• Velopharyngeal insufficiency
• Speech therapy