Comparison of sensitivity and specificity of mirror test and cephalometry in assessing velopharyngeal insufficiency after reconstruction of cleft palate

The velopharyngeal valve has an important role in controlling the flow of air during speech and incomplete velopharyngeal closure causes problems with speech. There are several modalities to assess velopharyngeal insufficiency, including using the mirror test and cephalometric radiographs. This study aimed to determine the sensitivity and specificity of the mirror test and cephalometric radiography for velopharyngeal insufficiency examination in patients after cleft palate reconstruction. A cross-sectional analytic study with a specific design for a diagnostic test was conducted. Data was grouped in a 2 × 2 table using the gold standard endoscopic examination. Data was obtained from patients aged 5–11 years after reconstruction of cleft palate and speech therapy in the SEHATI Program at Children and Maternal Hospital Harapan Kita Jakarta. Cephalometric radiographs had a higher sensitivity (100%) but lower specificity (33.3%) compared to the mirror test. The false-negative rate of cephalometric radiographs was 66.66%. Cephalometric radiographs have a higher sensitivity than the mirror test (the initial method of examination method) and can be used for velopharyngeal insufficiency examination along with the mirror test. (paper)