Velopharyngeal insufficiency is a disorder of structure that causes a failure of the velum (soft palate) to close against the posterior pharyngeal wall (back wall of the throat) during speech in order to close off the nasal cavity during oral speech production.

Causes include a history of cleft palate, adenoidectomy, irregular adenoids, cervical spine anomalies, or oral/pharyngeal tumor removal.

Causes may include stroke, traumatic brain injury, cerebral palsy, or neuromuscular disorders.

The patient may develop compensatory productions for consonants, where the sounds are produced in the pharynx (throat area) where there is adequate airflow.

[5][6] Nasometry is a method of measuring the acoustic correlates of resonance and velopharyngeal function through a computer-based instrument.

[7][8] Nasopharyngoscopy is endoscopic technique in which the physician or speech pathologist passes a small scope through the patient's nose to the nasopharynx.

The advantage of this technique over videofluoroscopy is that the examiner can see the size, location, and cause of the velopharyngeal opening very clearly and without harm (e.g., radiation) to the patient.

The disadvantage of this technique is that the vertical level velar elevation is less obvious than with videofluoroscopy, although this is not a big concern.

[9][10][11] Multiview videofluoroscopy is a radiographic technique to view the length and movement of the velum (soft palate) and the posterior and lateral pharyngeal (throat) walls during speech.

MRI uses the property of nuclear magnetic resonance to image nuclei of atoms inside the body.

In addition, different studies show that the MRI is better as an imaging tool than videofluoroscopy for visualizing the anatomy of the velopharynx.

Speech therapy is appropriate to correct the compensatory articulation productions that develop as a result of velopharyngeal insufficiency.

The goal of every operation is to achieve the best possible result with the technique assigned to each individual case, without causing upper airway obstruction and sleep apnea.

As a result, the tissue flaps cross each other, leading to a smaller port in the middle and a shorter distance between the palate and posterior pharyngeal wall.

Secondly the dynamic sphincter can be moved as result of a remaining neuromuscular innervation, which gives a better function of the velopharyngeal port.

Many materials have been used for this closure: petroleum jelly, paraffin, cartilage, adjacent soft tissue, silastic, fat, Teflon and proplast.

The palatal lift prosthesis is comparable with the speech bulb, but with a metal skeleton attached to the acrylic body.

[30] It is a good option for patients that have enough tissue but a poor control of the coordination and timing of velopharyngeal movement.

[2] Hospital will release the patient when it is appropriate and give clear instructions for pain management, wound care and cleansing and dietary modifications.

Generally post surgery instructions could include: If a patient experiences any increased pain, swelling, redness, bleeding or drainage from the surgical site, as well as fever or chills, parents should promptly contact their healthcare provider for further evaluation and management.

The word velopharyngeal uses combining forms of velo- + pharyng-, referring to the soft palate (velum palatinum) and the pharynx.