ear, nose, and throat disorders
Velopharyngeal Insufficiency
Introduction
Velopharyngeal insufficiency is incomplete closure of a sphincter between the oropharynx and nasopharynx, often resulting from anatomic abnormalities of the palate and causing hypernasal speech. Diagnosis is direct inspection with a fiberoptic nasoendoscope. Treatment is with speech therapy and surgery. Velopharyngeal insufficiency is incomplete closure of the velopharyngeal sphincter between the oropharynx and the nasopharynx. Closure, normally achieved by the sphincteric action of the soft palate and the superior constrictor muscle, is impaired in patients with cleft palate, repaired cleft palate, congenitally short palate, submucous cleft palate, palatal paralysis, and, sometimes, enlarged tonsils. The condition may also result when adenoidectomy or uvulopalatopharyngoplasty is done in a patient with a congenital underdevelopment (submucous cleft) or paralysis of the palate. 