Velopharyngeal Function and Velopharyngeal Dysfunction (Insufficiency)
The Velopharyngeal Dysfunction Clinic staff at Cincinnati Children's Hospital Medical Center explains normal velopharyngeal function and the causes of causes velopharyngeal dysfunction (VPD).
What is normal velopharyngeal function?
In order to close off the nose from the mouth during speech, several structures come together to achieve "velopharyngeal closure." These include the following:
- Velum (soft palate)
- Lateral pharyngeal walls -- side walls of the throat
- Posterior pharyngeal wall -- the back wall of the throat (See figures 1 and 2)
Through sphincter-like closure, these structures close off the oral cavity (mouth) from the nasal cavity (nose) during speech. This allows the speaker to build up air pressure in the mouth to produce various consonant sounds with normal pressure and normal oral resonance.
Velopharyngeal closure also occurs during other activities such as swallowing, gagging, vomiting, sucking, blowing and whistling.
What causes velopharyngeal dysfunction (VPD)?
Velopharyngeal dysfunction (VPD) is also known as velopharyngeal insufficiency (VPI) or even velopharyngeal incompetence (VPI).
The most common cause of velopharyngeal dysfunction is a history of cleft palate or submucous cleft. However, other causes include a short velum, cranial base anomalies, a history of adenoidectomy, surgery for midface advancement, enlarged tonsils, and irregular adenoids. Neuromotor disorders can cause poor velopharyngeal movement, resulting in velopharyngeal dysfunction.
How does velopharyngeal dysfunction affect speech?
Velopharyngeal dysfunction can cause the following speech characteristics:
- Hypernasality which is too much sound in the nose during speech
- Nasal air emission during consonant production
- Weak or omitted consonants due to inadequate air pressure in the mouth
- Short utterance length due to the loss of air pressure through the nasal cavity (nose)
- Compensatory articulation productions.
How is velopharyngeal dysfunction treated?
The treatment of velopharyngeal dysfunction may include speech therapy, or surgical intervention, such as a pharyngeal flap, sphincteroplasy or posterior pharyngeal wall implant. Prosthetic devices can also be used on a temporary or permanent basis in some cases.
Although surgery is often needed to correct the structure, changing structure does not change function. Therefore, postoperative speech therapy is usually required to help the patient learn how to make the best use of the surgical correction and to correct the compensatory articulation errors that resulted due to the velopharyngeal dysfunction .
For more information about the Velopharyngeal Dysfunction Clinic, contact Angela Davis, 513-636-0336.
