Tubomanometry in measurement of velopharyngeal closure: A pilot study

Abstract

Objective To investigate the differences in velum closure pattern in people with and without a history of middle ear disease using intranasal pressure curves recorded with the tubomanometer, a Eustachian tube (ET) testing device. Study Design Case control study. Setting Tertiary referral center. Subjects and Methods Tubomanometry nasopharyngeal pressure curves from 20 controls (Group 1) and 20 people with history of otitis media (OM) and possible ongoing ET dysfunction (ETD) (Group 2 or OM/ETD group) were compared. The variables included in the analysis were: (a) ratio of signal amplitude relative to the delivered nasal pressure (C2/delivered pressure x 10); (b) time (s) to achieve maximal signal amplitude (C2‐C1); (c) duration of velum closure (s) and (d) plateau decay during the isometric contraction of the velum (C3‐C2) and (e) swallow duration (s) (C4‐C1). Statistical analysis was conducted using mixed models for the normalized values of individual characteristics. Results Age, race and sex distribution in each group was as follows: 24 ± 8 years, 15 whites and 12 females in Group 1; 20 ± 10 years, 19 whites and 15 females in Group 2. Group 2 demonstrated a greater velopharyngeal pressure decay ( p = .13), longer swallow duration ( p = .10), and longer duration of velum closure ( p = .14). Conclusion This is the first study using tubomanometry to investigate differences in velopharyngeal closure between controls and individuals with OM/ETD. Although not statistically significant, our results showed that those with OM/ETD demonstrated a longer swallow and velum closure duration, and a higher degree of leakage during velum contraction compared to controls.