Velopharyngeal Insufficiency

Velopharyngeal Insufficiency 

Definition

Velopharyngeal insufficiency is the improper closing of the velopharyngeal sphincter (soft palate muscle) during speech characterized by an acute nasal quality of the voice.

Description

At the back of the mouth is a circle of structures that include the tonsils, the tongue, and the palate. During speech, this apparatus must close off the nose for proper articulation of the explosive consonants "p," "b," "g," "t," and "d." If it does not close, there is a snort sound produced through the nose. Improper function of this structure also produces a nasal tone to the voice.

Causes and symptoms

There are three main causes for this defect:

The primary symptom is the speech impediment. Some people develop a change in their speaking pattern or a series of facial grimaces to try to overcome the difficulty. If the condition is acute, regurgitation through the nose may occur.

Diagnosis

Examination of the velopharyngeal sphincter through ultrasound scans, fiber-optic nasopharyngoscopy, and videofluoroscopy will reveal the extent of velopharyngeal insufficiency. Speech and velopharyngeal sphincter movement are compared to make the diagnosis.

Treatment

Velopharyngeal insufficiency is treated with a combination of surgery and speech therapy. There are several surgical procedures that can be performed to correct the physical malfunction. They include:

Prognosis

The combination of surgery to correct the insufficiency and speech therapy to retrain the voice successfully alleviate velopharyngeal insufficiency.

Key terms

Adenoids — Lymph glands just above the tonsils and the palate.

Cleft palate — Congenital defect marked by a split in the roof of the mouth.

Nasopharyngoscopy — A diagnostic procedure that examines the nasal passageways and pharynx with an instrument outfitted with an optical system.

Pharynx — A canal located between the mouth cavity and the esophagus.

Tonsillectomy — Surgical removal of the tonsils.

Tonsils — Lymph glands in the throat, just behind the back teeth.

Resources

Periodicals

Huang M. H., S. T. Lee, and K. Rajendran. "Anatomic Basis of Cleft Palate and Velopharyngeal Surgery: Implications from a Fresh Cadaveric Study." Plastic & Reconstructive Surgery 101 (Mar. 1998): 613-627.

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velopharyngeal insufficiency

n.

An anatomical deficiency in the soft palate or superior constrictor muscle resulting in the inability to achieve velopharyngeal closure and often resulting in defective speech.