Velopharyngeal Insufficiency (VPI)

Overview:

Velopharyngeal insufficiency is a structural disorder characterized by an inadequate closure of the velopharyngeal port, typically due to anatomical deficits such as cleft palate, submucous cleft, or post-surgical scarring. This insufficiency prevents effective separation of the nasal and oral cavities during speech, resulting in excessive nasal resonance (hypernasality), nasal air emission, and sometimes nasal regurgitation during swallowing. Unlike velopharyngeal incompetence (a neuromotor issue), VPI is primarily caused by tissue deficiency or abnormal anatomy. It often requires surgical intervention, such as pharyngeal flap or sphincter pharyngoplasty, sometimes in conjunction with speech therapy to optimize function and intelligibility.

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Sources:

Luke J. Schloegel, “Velopharyngeal Dysfunction (Practice Essentials),” (2024).

Ann W. Kummer, Cleft Palate & Craniofacial Anomalies: Effects on Speech and Resonance, 4th ed. (Clifton Park, NY: Cengage, 2020).