Velopharyngeal insufficiency surgery. This velopharyngeal (VP) closure is especially important when producing pressure sensitive sounds. Although the several surgical treatments of VPI have been introduced, there is no consensus guide to select the optimal surgical treatment for VPI patients. The aim of this study was to evaluate speech outcomes following surgical intervention for velopharyngeal dysfunction (VPD). Symptoms of velopharyngeal insufficiency include a hypernasal voice with an inability to form speech sounds correctly. The aim of this study was to assess if the decision for velopharyngeal insufficiency (VPI) surgery can be made by the age of 3 years among CP children with moderate-to-severe To evaluate the effect of an ACPA-approved multidisciplinary team on velopharyngeal insufficiency (VPI) diagnosis and treatment Retrospective Cohort Tertiary Children’s Hospital Children with cleft palate repair identified through procedure codes Jul 28, 2023 · Speech therapy improves velopharyngeal function when VPD is minimal or due to articulation errors and in postoperative patients. Diagnosis is direct inspection with a fiberoptic nasoendoscope. The absence of this ability, termed velopharyngeal insufficiency (VPI), is seen in a wide range of patients following primary cleft palate repair. Surgery: The size and shape of your child's velopharyngeal gap will dictate the type of surgery that is necessary. J Craniofac Surg. The purpose of this study is to evaluate the comparative incidence of OSA following VPI surgery in the United States. Perceptual speech outcome data were subsequently analyzed in conjunction with patient factors such as congenital The diagnosis and management of secondary velopharyngeal insufficiency are discussed. Prospective observational cohort. Oct 31, 2019 · A working group of practitioners with advanced training and experience in the management of patients with cleft palate/velopharyngeal disorders, including representatives from speech-language pathology, otolaryngology, and plastic surgery, was formed. Nov 2, 2024 · The velopharyngeal insufficiency (VPI) is the inability of the velopharyngeal sphincter to seal the communication between the nasal cavities and the inferiorly located rest of the vocal tract during speech. The authors aim to evaluate these findings in a large cohort study using causal inference. The current study characterized a small cohort of adult patients with acquired VPI, dysphonia, and To our knowledge, there have been few studies investigating the outcome of pharyngeal flap as secondary speech surgery for treating velopharyngeal insufficiency from Saudi Arabia and Middle East region. The treatment options presented in the literature are varied, covering invasive and non-invasive Providers at NYU Langone’s Velopharyngeal Dysfunction Clinic manage all forms of the condition—diagnosed in childhood—with speech therapy, surgery, or both. Despite surgical repair of the cleft, approximately 20% of these patients demonstrate velopharyngeal insufficiency owing to either inadequate velar length following the repair or velopharyngeal incompetence due to poor muscle function. VPD occurs when the soft palate cannot properly separate the back of the mouth from the nose during speech. The authors review diagnostic modalities including perceptual speech assessment, video nasendoscopy, fluoroscopy, magnetic resonance imag … Feeling out of your depth when it comes to assessing speech and resonance in kids with cleft palate? Never fear—this Ask TISLP series has your back. Learn more. How Does A Speech Therapist Treat Velopharyngeal Insufficiency? If your child does have velopharyngeal insufficiency, the first step in correcting it is surgery. The specific treatment plan, surgery, speech therapy, or rehabilitation therapy is best determined by various types of fluoroscopy and viewing of the nasal cavity. It’s often done before and after surgery. Although there exist many approaches to treating VPI depending on the shape and severity of the insufficiency, this chapter describes the three most frequently used and well 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. . 2–5 The velopharyngeal mechanism is a muscular valve extending from the posterior bony palate to the posterior pharynx. In this procedure, called augmentation pharyngoplasty, injectable fillers are used to close the gap. Doctors suspect velopharyngeal insufficiency in people with the typical speech abnormalities. VPI clinic Overview Velopharyngeal insufficiency (VPI) is an inability to effectively seal the nose from the mouth during speech. The video could also be used as an explanatory tool by healthcare professionals. Oronasal fistulas of the hard palate and large nasoalveolar fistulas should be closed before proceeding with speech surgery Introduction Patients with velopharyngeal insufficiency (VPI) are typically children who are born with cleft lip or palate. VPI Abstract Objectives: Velopharyngeal insufficiency (VPI) may be due to functional or anatomic causes, and can lead to speech deficits, communication difficulty, and emotional strain on patients and their caregivers. Speech therapy can help your child adjust the way they speak to reduce the sounds of VPI. In essence, during the act of swallow or talking with certain sounds, the uvulo-palate structure lifts and seals against Overview of Treatment Techniques for Velopharyngeal Insuffiency What Is VPI? Velopharyngeal Insufficiency (VPI) is a resonance disorder associated with a natural "pressure valve" in the back of the mouth that does not maintain air pressures that are needed in typical speech production. Speech assessment and velopharyngeal imaging are critical to identifying which patients are proper candidates for speech surgery and to guide procedure selection. Treatment of patients with cleft palate is one of the most difficult problems in Aug 1, 2024 · To treat patients with cleft palate effectively, the surgeon must understand the diagnosis and surgical management of cleft-associated velopharyngeal dysfunction. May 1, 2025 · This study evaluated the outcomes of perceptual speech, breathing, snoring, and nasal regurgitation following Orticochea pharyngoplasty, and investigated patient characteristics associated with the resolution or improvement of velopharyngeal insufficiency (VPI) in cleft patients. 2024; 32:239-247 Google Scholar Abstract Velopharyngeal insufficiency (VPI) after palatoplasty is caused by improper anatomy preventing velopharyngeal closure and manifests as a hypernasal resonance, audible nasal emissions, weak pressure consonants, compensatory articulation, reduced speech loudness, and nostril or facial grimacing. Feb 20, 2025 · In addition to surgery, prosthetic options exist to aid in the treatment of VPD and may be utilized temporarily or serve as a permanent solution for nonsurgical candidates. Speech therapy is usually needed after the The treatment for velopharyngeal mislearning requires speech therapy only. The accompanying videos demonstrate the features of the cleft lip nasal deformities and reliable surgical techniques for unilateral cleft lip repair, bilateral cleft lip repair, and radical intravelar veloplasty. Pharyngoplasty is an operation to change the shape and function of your soft palate and the area around it (your pharynx). Treating Velopharyngeal Insufficiency at Cleveland Clinic Children’s There are two main ways to treat velopharyngeal insufficiency in children — speech therapy and surgery. What Causes Velopharyngeal Dysfunction (VPD)? Different things can cause velopharyngeal (vee-low-fair-en-JEE-ul) dysfunction, including: history of cleft palate submucous cleft palate 22q11. When surgery is needed, it does not change the way the child has already learned to talk. A The size and shape of the velopharyngeal gap will dictate the type of surgery that is necessary. The VPI Effects on Life Outcomes (VELO) instrument quantifies quality of life outcomes in VPI patients both before and after VPI surgery. The superiorly based flap is elevated from the posterior pharyngeal wall, rotated and attached to the soft palate (velum), to obstruct 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. A surgical procedure (i. However, this condition may also be caused as a complication of an overly aggressive tonsillectomy, adenoidectomy, uvula and/or palate (UPPP) surgery. Dec 14, 2017 · Speech outcomes and velopharyngeal function after surgical treatment of velopharyngeal insufficiency in individuals with signs of velocardiofacial syndrome. The management types are as follows: speech therapy, surgery, speech bulb, and others. When symptomatic, VPI can cause hypernasal or unintelligible speech. Proponents of this classification system describe VP insufficiency in patients who have cleft palate or other anatomic factors that contribute to VPD. Mar 1, 2015 · Velopharyngeal insufficiency is important to recognize in the long-term care of patients with a history of a cleft palate. The study involved a retrospective review of consecutive patients who underwent Orticochea pharyngoplasty for VPI 6 days ago · Velopharyngeal Insufficiency (VPI) must be corrected by a surgical procedure or a prosthetic appliance. Treatment options for velopharyngeal insufficiency consist of prosthetic management or surgery, supplemented with speech therapy when appropriate. Velopharyngeal closure (VPC) is an important part of speech. Velopharyngeal dimensions change as a child with cleft palate (CP) grows. This article discusses patient assessment, treatment options, and the surgical management of VPI. 2006). A speech evaluation is recommended approximately six weeks after surgery to re-evaluate speech and determine if therapy is recommended. Closure of the velopharyngeal sphincter is normally achieved by the sphincteric action of 1) Define the minimal clinically important difference (MCID) of the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) instrument, and 2) test for change in quality of life after VPI surgery. The diagnosis and preoperative evaluation is contingent on collaborative evaluation between the surgeon and speech-language pathologist. Pertinent literature was reviewed, and practical suggestions for clinicians were developed through consensus discussion. Background Velopharyngeal insufficiency (VPI) is a major complication of cleft palate repair. It can sometimes develop after tonsil or adenoid surgery or result from muscle weakness in people with neurologic disorders such as cerebral palsy, stroke, or brain tumors. Patients with a repaired cleft palate and velopharyngeal insufficiency are fully managed by a multidisciplinary team with a subjective and objective Oct 13, 2021 · Velopharyngeal insufficiency (VPI) is a condition where the soft palate and posterior oropharynx fail to close adequately, leading to complications such as abnormal speech, nasal regurgitation and nasal emission. Sub-optimal surgical results may cause velopharyngeal insufficiency (VPI). 2024; 32:239-247 Google Scholar Dec 1, 2015 · Velopharyngeal insufficiency is the inability to completely close the velopharyngeal port during speech production or feeding. Our study aimed to evaluate the effectiveness of the superiorly based pharyngeal flap to treat persistent VPI post cleft palate repair. There are three main surgeries that are done to manage VPI. However, in patients with a specific anatomic deficiency that precludes adequate closure of the velopharynx, speech therapy 6 days ago · Posterior pharyngeal wall augmentation is a surgical intervention for managing velopharyngeal insufficiency (VPI) in patients with adequate palatal mobility but small persistent gaps. Velopharyngeal insufficiency is defined as a degree of nasality that interferes with resonance quality and comprehensibility. The postoperative risk of VPI varies … There can be a significant social stigma associated with velopharyngeal dysfunction, and surgical treatment can be curative in many cases. Surgical Jun 21, 2024 · Velopharyngeal movements during phonation are quite distinct from those involved in swallowing, as is clinically evident in patients who are able to obtain good closure during swallowing yet are unable to obtain adequate closure when speaking. If it is determined that your child has VPI and needs surgery, different options are discussed with the patient/family/caregivers. Speech characteristics related to velopharyngeal function (VPF) were analyzed by auditory-perceptual assessment using digital audio recording 5 days before and 13 months after the palate Resonance Disorders and Velopharyngeal Dysfunction: Assessment and Intervention Ann W. Posterior Pharyngeal Flap (PPF) is a surgery done to help correct velopharyngeal dysfunction, or VPD. Understand the symptoms, causes, diagnosis, and treatment options for velopharyngeal insufficiency to ensure timely care and improve outcomes. Jan 3, 2025 · Study design: Systematic review. The anatomical components of the velopharyngeal sphincter Oct 12, 2023 · Nonsyndromic individuals with operated cleft palate ± lip and velopharyngeal insufficiency (VPI), aged 6–22 years (10 men and 10 women), were referred to secondary palate surgery by the Sommerlad technique. 6 days ago · Velopharyngeal insufficiency (VPI) is a structural disorder characterized by inadequate closure of the velopharyngeal (VP) port during speech, leading to hypernasality and nasal air escape. The selection of surgical treatment for VPI de-pends on a multimodal patient evaluation, such as perceptual speech evaluation, nasometery and Aug 17, 2025 · MediFind found 1014 doctor with experience in Velopharyngeal Insufficiency. Velopharyngeal dysfunction (VPD) describes disorders characterized by the abnormal function of the velopharyngeal valve, which can cause complications with swallowing and speech. The size and shape of the velopharyngeal gap will dictate the type of surgery that is necessary. Velopharyngeal insufficiency (VPI) is a common complication after primary palatoplasty. 1) Define the minimal clinically important difference (MCID) of the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) instrument, and 2) test for change in quality of life after VPI surgery. However, in patients with a specific anatomic deficiency that precludes adequate closure of the velopharynx, speech therapy cannot replace surgery. Velopharyngeal insufficiency specifically refers to an anatomic deficiency, which subsequently impairs resonant control of speech and intraoral pressure for orally directed speech sounds. Various surgical techniques are used to treat secondary velopharyngeal insufficiency after cleft palate repair, but the optimal procedure remains debatable. Kummer, PhD, CCC-SLP Limitations of a Prosthetic Device Requires insertion and removal Has to be redone periodically due to growth Dec 10, 2024 · By Marvee Turk, Pragaash Shanmuganathan & 2 more. Surgery is indicated if the symptoms of VPI cannot be improved by speech therapy. May 1, 2025 · Abstract Background: The timing of primary repair in nonsyndromic cleft palate remains controversial. The treatment of velopharyngeal insufficiency or velopharyngeal incompetence usually requires a surgical procedure (tonsillectomy, pharyngeal flap, sphincter pharyngoplasy, or posterior pharyngeal wall implant). Jul 28, 2023 · Speech therapy Speech therapy improves velopharyngeal function when velopharyngeal dysfunction (VPD) is minimal or due to articulation errors and in postoperative patients. The treatment of velopharyngeal insufficiency or velopharyngeal incompetence usually requires surgery. Speech therapy improves velopharyngeal function in patients whose VPD is minimal or due to articulation errors and in postoperative patients. However, surgery is the The nasal and oral cavities must be completely closed off during swallowing, vomiting, blowing, sucking, whistling, and talking. This study aims to identify pre-operative Velopharyngeal insufficiency can result in hypernasal speech and nasal resonance. (See Helping Hand HH-I-448, Velopharyngeal Dysfunction for more Jan 12, 2023 · Velopharyngeal insufficiency (VPI) is a disorder of the velopharyngeal sphincter or valve, which separates the nasal and oral cavities during speech, swallowing, vomiting, blowing, and sucking. The purpose of this study was to evaluate the incidence and predictive factors of VPI after cleft palate repair based on 27 years of one surgeon's 6 days ago · Update on using buccal myomucosal flaps for patients with cleft palate and velopharyngeal insufficiency - primary and secondary interventions Current Opinion in Otolaryngology & Head and Neck Surgery. e. Velopharyngeal dysfunction (VPD) describes any condition whereby the velopharyngeal valve does not properly close during the production of oral sounds. Make sure you grab our jam-packed clinical download, including a visual explanation of velopharyngeal dysfunction and VPI, an assessment outline, and tons of resources. Children with VPI often speak in a very nasal tone, such that, with certain sounds, air will leak from the nose, making the words hard to understand. VPD contains multiple causes, including velopharyngeal mislearning (nasopharyngeal sound substitution for an oral sound), velopharyngeal incompetence (neurolophysiologic dysfunction causing poor pharyngeal movement), and velopharyngeal The absence of this ability, termed velopharyngeal insufficiency (VPI), is seen in a wide range of patients following primary cleft palate repair, with approximately 20-30% requiring secondary surgical correction. This technique is most suitable for large incompetency of the VP sphincter which do have lateral pharyngeal wall motion. Preoperative speech therapy is useful, and in some children may provide definitive treatment. This review provides an overview of the Dec 24, 2024 · How does velopharyngeal insufficiency affect speech and what treatments are available? Read on to learn more about this speech condition, including its possible causes. During normal VP function, the posterior third of the soft palate moves posterior-superiorly, while the pharyngeal wall moves anteriorly and medially to form a Jun 10, 2016 · One of the main risks of uvula excision and UPPP (uvulopalatopharyngoplasty) surgery to treat snoring and obstructive sleep apnea is velopharyngeal insufficiency (VPI). A thorough history and a complete head and neck Nov 16, 2022 · This chapter details a simplified patient- and surgeon-friendly algorithm to obtain a satisfactory improvement of velopharyngeal function with a low risk of airway complications in patients with postpalatoplasty velopharyngeal insufficiency. Knowledge of the normal anatomy and physiology of the velopharyngeal complex is essential when planning for surgical repair. Treatment is with speech therapy and surgery. 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. Recent evidence suggests earlier repair is associated with a lower incidence of velopharyngeal insufficiency (VPI). Adults can develop VPI after neurological problems (like strokes), previous surgery to the palate, or radiation treatment of The absence of this ability, termed velopharyngeal insufficiency (VPI), is seen in a wide range of patients following primary cleft pal-ate repair, with approximately 20-30% requiring secondary surgical correction. Surgical interventions are palatal, palatopharyngeal or pharyngeal in nature. 5 days ago · Midline posterior myo-mucosal pharyngeal flap is the main “workhorse” surgery for the correction of velopharyngeal (VP) insufficiency. Jan 12, 2023 · Velopharyngeal insufficiency (VPI) is a disorder of the velopharyngeal sphincter or valve, which separates the nasal and oral cavities during speech, swallowing, vomiting, blowing, and sucking. Velopharyngeal insufficiency (VPI) is used to describe an anatomical or structural defect that prevents adequate velopharyngeal closure. Both options must be customized according to imaging findings as provided by Videonasopharyngoscopy (VNP) and Multiplanar Videofluoroscopy (MPVF). Animation video [In English] on Speech surgery: Pharyngoplasty Target audience: Patients and their families/carers. 2011;22:1736–1742. Posterior pharyngeal flap (PPF) surgery is a common surgical approach for managing VPI in this patient population. A retrospective analysis of a single surgeon’s experience of using the pharyngeal flap to manage velopharyngeal insufficiency regardless of velopharyngeal closure pattern. Objective: Obstructive sleep apnea (OSA) is a possible complication following secondary velopharyngeal insufficiency surgery in patients with repaired cleft palate. Children and adults with VPD often have nasal-sounding speech, with abnormal air leaking through the nose as they talk. It results from a discrepancy of velar length versus the depth of the nasopharynx, or from insufficient lifting of the velum towards the posterior pharyngeal wall. The most common types of surgery for VPI are a posterior pharyngeal wall injection augmentation, furlow palatoplasty, pharyngeal flap or sphincter pharyngoplasty. This process is known to be associated with dysphagia and dysphonia but surgical interventions for these complex patients have not been well studied. Speech-language pathologists (SLPs) play a crucial role in the assessment and Apr 3, 2025 · Surgery is a mainstay of treatment for more significant gaps, but physicians increasingly opt for a nonsurgical approach in select patients. Prospective observational cohort. 2 deletion syndrome frequently present with velopharyngeal insufficiency (VPI), often due to characteristic craniofacial anomalies such as a shortened palate and a wide anterior-to-posterior velopharyngeal gap. Bot VerificationVerifying that you are not a robot Abstract Velopharyngeal inadequacy may be learned, neurologic, or anatomic in origin. Diagnosis is confirmed through imaging techniques, such as nasendoscopy or videofluoroscopy, performed during speech tasks. This method serves as either a primary procedure or an Pharyngeal Flap & Sphincter Pharyngoplasty The goals of VPI (Velopharyngeal Insufficiency) surgery is to eliminate the symptoms of hypernasality and audible nasal emissions without causing total obstruction of the velopharyngeal port, allowing for nasal breathing and nasal resonance. Abstract Objectives: Velopharyngeal insufficiency (VPI) is a form of velopharyngeal dysfunction caused by abnormal or insufficient anatomy. Apr 6, 2021 · Key Points A good primary repair is essential for minimizing velopharyngeal dysfunction after palatoplasty. When the soft palate and pharyngeal walls cannot form an effective seal, an abnormal connection between the nasal and oral cavities leads to hypernasal speech, increased nasal resonance, regurgitation Through advanced surgical techniques and treatment options such as Velopharyngeal Dysfunction (VPD) surgery or speech therapy, we help your child feel their best. 2–5 The velopharyngeal mechanism is a muscular valve extending from the posterior bony palate to the posterior pharynx. What Are the Treatment Options for Velopharyngeal Dysfunction? The treatment of a velopharyngeal dysfunction depends on the type and cause of the problem. 6 days ago · Children with 22q11. Jan 27, 2019 · Here’s Everything You Need To Know About Velopharyngeal Insufficiency - What is Velopharyngeal Insufficiency, Causes, Symptoms, Treatment, Speech Therapy, Surgery Velopharyngeal insufficiency can be a postoperative sequela or congenital. Of these, 777 are Experienced, 192 are Advanced, 41 are Distinguished and 4 are Elite. The categories include velopharyngeal insufficiency, velopharyngeal incompetence, and velopharyngeal mislearning (Peterson-Falzone et al. By increasing posterior pharyngeal wall bulk, the technique aims to narrow the sphincter and improve velopharyngeal closure and reduce nasal air escape. Velopharyngeal insufficiency can occur in people born with a split in the roof of the mouth (cleft palate) or a palate that is too short. This is important because speech requires sound from the vocal folds and airflow from the lungs to be directed into the oral cavity Velopharyngeal insufficiency (VPI) is used to describe an anatomical or structural defect that prevents adequate velopharyngeal closure. Velopharyngeal dysfunction during speech can be diagnosed by a general assessment of the chair. Velopharyngeal dysfunction (VPD) is when sound and air leaks into the nose during speech. However, VPI (both velopharyngeal insufficiency and velopharyngeal incompetence) require physical management. Obstructive sleep apnea (OSA) is a troublesome complication following surgical management of velopharyngeal insufficiency (VPI). Learn more about speech therapy and treatment options in our VPI clinic. The development of a standardized minimum data set to record postoperative speech, OSA, and patient-reported outcomes is required. , a tonsillectomy, Furlow Z-plasty, pharyngeal flap, sphincter pharyngoplasty, or posterior pharyngeal wall implant) is usually required. When the soft palate and pharyngeal walls cannot form an effective seal, an abnormal connection between the nasal and oral cavities leads to hypernasal speech, increased nasal resonance, regurgitation Velopharyngeal Dysfunction Care at Seattle Children's Our doctors, surgeons, geneticists, audiologists, speech and language pathologists and other specialists offer the most comprehensive range of pediatric speech services in the Pacific Northwest. Among the operative methods, velopharyngoplasty constitutes the basis of the surgery. How Is Velopharyngeal Insufficiency Diagnosed? A speech pathologist can determine if your child’s speech deficit is caused by velopharyngeal insufficiency or something else. 1 Additionally, a minority of patients There is a lack of consensus in the literature to guide procedure selection for patients with VPD. 6 days ago · Update on using buccal myomucosal flaps for patients with cleft palate and velopharyngeal insufficiency - primary and secondary interventions Current Opinion in Otolaryngology & Head and Neck Surgery. Jun 6, 2023 · Children and adults who have velopharyngeal insufficiency (VPI) and nasal-sounding speech (hypernasality) may need pharyngoplasty. The velopharyngeal insufficiency (VPI) program at Children’s Hospital treats speech problems involving the palate or throat in children and teens. Velopharyngeal dysfunction, or VPD, is a condition resulting from inadequate closure of the velopharyngeal port, or the opening between the nose and the mouth, during speech. Compensatory articulation techniques secondary to VPD also can be corrected with speech therapy. Jul 1, 2024 · To evaluate pre- and post-operative resonance, surgical technique, revision rate, and revision indication among syndromic and non-syndromic children with velopharyngeal insufficiency (VPI). Velopharyngeal dysfunction (VPD) is the inadequate separation of the oral and nasal cavities during speech and/or swallowing. Velopharyngeal insufficiency may occur as a result of an anatomical or structural defect and may be present in patients with cleft lip and palate. Velopharyngeal insufficiency is the most common type of VPD because it includes a short or abnormal velum, which occurs in children with a history of cleft palate or submucous cleft. At Nationwide Children’s Hospital, our experts in the Velopharyngeal Dysfunction Program provide specialized treatment for patients with speech disorders resulting from VPD. Jul 25, 2022 · Management and Treatment How is velopharyngeal insufficiency treated? Velopharyngeal insufficiency treatment usually involves speech therapy and surgery. Velopharyngeal Insufficiency What Is Velopharyngeal Insufficiency (VPI)? Velopharyngeal insufficiency (VPI) is a disorder resulting in the improper closing of the velopharyngeal sphincter (soft palate muscle in the mouth) during speech, allowing air to escape through the nose instead of the mouth. 2 deletion syndrome (DiGeorge syndrome) problems with the palate Velopharyngeal Dysfunction: Surgery (continued) Before the surgery Address anxiety issues Undergo imaging studies Nasopharyngoscopy and/or video fluoroscopy for diagnosis and surgical planning MRI to determine carotid artery position Does secondary speech surgery improve velopharyngeal insufficiency (VPI)-specific quality of life (QOL), as measured with the VELO instrument? In this prospective study of 29 children and young adults, VELO scores were statistically significantly Sep 1, 2023 · Cleft palate is among the most common congenital disorders worldwide and is correctable through surgical intervention. Severe velopharyngeal insufficiency can cause solid foods and fluids to regurgitate through the nose. 5o3klh 5lqd3 9rx zx leab twafko uilc gau ajk1 7gxbu