Semin Plast Surg 2012; 26(04): 170-177
DOI: 10.1055/s-0033-1333882
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Velopharyngeal Dysfunction

Albert S. Woo
1   Cleft Palate-Craniofacial Institute and Department of Surgery, Washington University in St. Louis, St. Louis, Missouri
› Author Affiliations
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Publication History

Publication Date:
13 February 2013 (online)

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Abstract

Velopharyngeal dysfunction (VPD) is a generic term which describes a set of disorders resulting in the leakage of air into the nasal passages during speech production. As a result, speech samples can demonstrate hypernasality, nasal emissions, and poor intelligibility. The finding of VPD can be secondary to several causes: anatomic, musculoneuronal, or behavioral/mislearning. To identify the etiology of VPD, patients must undergo a thorough velopharyngeal assessment comprised of perceptual speech evaluation and functional imaging, including video nasendoscopy and speech videofluoroscopy. These studies are then evaluated by a multidisciplinary team of specialists, who can decide on an optimal course for patient management. A treatment plan is developed and may include speech therapy, use of a prosthetic device, and/or surgical intervention. Different surgical options are discussed, including posterior pharyngeal flap, sphincter pharyngoplasty, Furlow palatoplasty, palatal re-repair, and posterior pharyngeal wall augmentation.