Miyastenia Gravis'de Velofaringeal Fonksiyonun Araştırılması

Abstract

Velopharyngeal incompetency is the inability of velopharyngeal valve closure during speech and deglutution. It effects the speech intelligibility and quality of life by means of allowing the air to escape through the nasal cavity and nasal regurgitation during deglutition. A significant part of the diseases which cause velopharyngeal incompetency are neuromuscular diseases. But, there is not enough research in literature showing that velopharyngeal incompetency is seen in Myasthenia Gravis patients. Knowing to velopharyngeal incompetency is one of the manifestations of some Myasthenia Gravis patients is important to specify any treatment and rehabilitation approaches in these patients. The aim of present study is to assess velopharyngeal mechanism and reveal the presence of velopharyngeal incompetency in Myasthenia Gravis patients. Twenty Myasthenia Gravis patients with generalize muscle weakness were taken to the study and they divided into 2 subgroups based on bulbar muscle involvement. Additionally 10 healthy people were taken as a control group. Nasalance scores were determined via nasometer evaluation. Nasopharyngeal imaging was performed to indicate the quantitiy of velopharyngeal movement and closure pattern during speech, blowing, dry swallowing and food swallowing. 50% of the Myasthenia Gravis patients with bulbar muscle involvement showed velopharyngeal incompetancy. There was not velopharyngeal incompetancy signs in patients without bulbar muscle involvement. Patients with bulbar muscle involvement showed weakness of velopharyngeal closure. This weakness was different among the pneumatic and non-pneumatic activities. Additionally, there was no difference among the groups in terms of velopharyngeal closure patterns. In conclusion, we state that velopharyngeal incompetancy is one of the manifestations in Myasthenia Gravis patients with bulbar muscle involvement and velopharyngeal mechanism differs according to the activity being performed in these patients.