Cleft Speech 3 - Speech Imaging

Summary

In this video, Dr. James Seaward, a pediatric plastic and cleft surgeon, discusses the evaluation process for children with cleft palates who have velopharyngeal dysfunction (VPD), affecting their speech. He explains the use of speech imaging studies, including lateral video fluoroscopy and video naso-endoscopy, to assess palate movement during speech. These studies help determine if surgery is beneficial and which type of operation is most suitable for the child. Dr. Seaward emphasizes the importance of a collaborative approach involving speech therapists and imaging data to make informed decisions about treatment.

Takeaways

• 👨‍⚕️ James Seaward is a pediatric plastic and cleft surgeon at UT Southwestern Medical Center, specialized in treating children with cleft-related speech issues.
• 🗣️ Children with clefts can have velopharyngeal dysfunction (VPD), a resonance error where too much air escapes through the nose during speech.
• 🔍 To assess VPD, speech imaging studies are conducted, including lateral video fluoroscopy and video naso-endoscopy, to observe the palate's movement during speech.
• 📹 Lateral video fluoroscopy uses x-ray technology to view the palate's side movement, helping to identify issues with the soft palate's contact with the back of the throat.
• 👄 Video naso-endoscopy involves a camera in the mouth and nose, providing direct visualization of the soft palate's movement and its ability to form an effective valve.
• 👶 The speech imaging studies help determine if surgery could benefit a child's speech and which operation might be most suitable.
• 🤝 A multidisciplinary team, including speech therapists and surgeons, evaluates the child to decide on the best course of action for speech improvement.
• 📊 The imaging studies provide valuable data on the palate's movement, gaps, and force required for an effective valve system, crucial for surgical planning.
• 🌐 For more information about James Seaward and his practice, viewers are directed to his website, www.drseaward.org.
• 🔄 In upcoming videos, Dr. Seaward will discuss the different types of speech surgeries he offers to address VPD in children.

Q & A

What is the main focus of the discussion led by James Seaward?

The main focus is on investigating children born with a cleft who struggle with speech, particularly those suspected to have velopharyngeal dysfunction (VPD), where too much air escapes from their nose when they talk.

What is velopharyngeal dysfunction (VPD)?

Velopharyngeal dysfunction (VPD) is a type of resonance error where the soft palate does not make proper contact with the back of the throat during speech, leading to excessive nasal airflow and affecting speech clarity.

What role does James Seaward play at UT Southwestern Medical Center?

James Seaward is a pediatric plastic and cleft surgeon at UT Southwestern Medical Center in Dallas, Texas, specializing in the treatment of children born with clefts.

What are the two speech imaging studies mentioned for evaluating VPD?

The two speech imaging studies mentioned are lateral video fluoroscopy and video naso-endoscopy. These studies help in assessing the movement of the palate during speech and determining the appropriate surgical intervention.

How does lateral video fluoroscopy help in evaluating a child's speech?

Lateral video fluoroscopy uses x-ray technology to observe the palate from the side as the child speaks, allowing the medical team to see the movement of the hard and soft palate and identify any issues with the valve system.

What information can video naso-endoscopy provide during a speech evaluation?

Video naso-endoscopy involves placing a small camera into the mouth and nose to directly observe the soft palate's movement. It provides detailed images of the palate's contact with the throat and can show differences in movement between the right and left sides.

Why is the speech therapist evaluation important in deciding on surgery for speech?

The speech therapist evaluation is crucial as it provides a comprehensive assessment of the child's speech patterns and difficulties. This information, combined with the findings from speech imaging studies, helps determine if surgery is beneficial and which type of surgery would be most effective.

What examples of palate movement issues are shown during the video fluoroscopy?

Examples shown include touch closure where the soft palate barely reaches the back of the throat, small and large consistent gaps, and a palate that is not moving well at all.

How does the presence of bubbles in the video naso-endoscopy indicate a problem?

Bubbles seen in the video naso-endoscopy indicate that air is escaping through the valve system, suggesting that the soft palate is not creating a proper seal against the throat, which is a sign of VPD.

What is the significance of the team approach mentioned by James Seaward?

The team approach is significant because it ensures a multidisciplinary evaluation of the child's condition. This includes input from speech therapists, surgeons, and other specialists, leading to a more informed decision on whether and what type of surgery would benefit the child's speech.

What can be expected in James Seaward's next video?

In his next video, James Seaward will discuss the different types of speech surgeries he offers, providing insight into the surgical options available for children with speech issues related to clefts.