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What is Nasendoscopy?
Nasendoscopy is a type of instrumental assessment allowing the speech-language pathologist an interior view of the nasal cavity as well as the velopharyngeal structures and patterns of movement. It is a critical tool in determining the etiology of hypernasal speech, planning speech surgery, identifying children with submucous cleft palates, and identifying adults with an acquired velopharyngeal disorders. This view allows the clinician to see the velum working in real-time by viewing its movements during the patient's production of running speech.
Source: Whitehill, T. L., & Lee, A. S. Y. (2009). Instrumental Analysis of Resonance in Speech Impairment. The Handbook of Clinical Linguistics, 56, 332.
Where Can I Learn More?
Cincinnati Children's Hospital offers an expert presentation on the science and the art of performing nasendocopy on children. Click on the link below:
http://www.cincinnatichildrens.org/WorkArea/DownloadAsset.aspx?id=121958
Educational Videos
Below are two videos helpful for understanding the procedure of nasendoscopy.
The first video demonstrates how nasendoscopy is performed. The second video demonstrates a rating tool for clinicians using nasendscopy to assess velopharyngeal functioning.
ASHA Position Statement on Nasendoscopy
"It is the official position of the American Speech-Language Hearing Association that fiberoptic endoscopy is an imaging procedure that may be utilized by speech-language pathologists to evaluate swallowing function. Fiberoptic endoscopy may also be utilized as a therapeutic aid and biofeedback tool during the course of swallowing treatment. The assessment and management of dysphagia falls within the scope of practice of speech-language pathology. Speech-language pathologists with expertise in dysphagia and specialized training in fiberoptic endoscopy are professionals qualified to use this procedure independently for the purpose of assessing swallowing function and related functions of structures within the upper aerodigestive tract. The procedure is not intended to replace the fiberoptic examination performed by the otolaryngologist to assess the integrity of the laryngeal and pharyngeal structures. Physicians use endoscopy for functional evaluation of swallowing and/or to assess the integrity of the laryngeal and pharyngeal structures in order to render a medical diagnosis. Within interdisciplinary settings, these medical diagnoses and swallowing function assessment procedures can be accomplished through the combined efforts of these related professionals. Care should be taken to use this examination only in settings where medical personnel are available to ensure patient safety."
Source: American Speech-Language-Hearing Association. (2005). The role of the speech-language pathologist in the performance and interpretation of endoscopic evaluation of swallowing: position statement [Position Statement]. Available from www.asha.org/policy.
Where to Get a Nasendoscope
PENTAX Medical, USA. (https://pentaxmedical.com/pentax/en/99/1/ENT-Speech/)
Olympus (http://medical.olympusamerica.com/specialty/ent)
Recommended Readings
Hay, I., Oates, J., Giannini, A., Berkowitz, R., & Rotenberg, B. (2009). Pain perception of children undergoing nasendoscopy for investigation of voice and resonance disorders. Journal of Voice, 23(3), 380-388.
Lam, D. J., Starr, J. R., Perkins, J. A., Lewis, C. W., Eblen, L. E., Dunlap, J., & Sie, K. C. (2006). A comparison of nasendoscopy and multiview videofluoroscopy in assessing velopharyngeal insufficiency. Otolaryngology-Head and Neck Surgery, 134(3), 394-402.
Kummer, A.W., Clark, S.L., Redle, E.E., Thomsen, L.L., and Billmire, D.A., (2012). Current Practice in Assessing and Reporting Speech Outcomes of Cleft Palate and Velopharyngeal Surgery: A Survey of Cleft Palate/Craniofacial Professionals. The Cleft Palate-Craniofacial Journal: March 2012, Vol. 49, No. 2, pp. 146-152.
Whitehill, T. L., & Lee, A. S. Y. (2009). Instrumental Analysis of Resonance in Speech Impairment. The Handbook of Clinical Linguistics, 56, 332.