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Cleft Lip & Palate

Velopharyngeal Dysfunction

 

Velopharyngeal Insufficiency/Incompetence  

Velopharyngeal Obstruction 

Air Escape 

Nasal air emission 

Obstruction to air emission 

Cause 

Insufficiency = structurally/anatomically unable to close velopharyngeal valve 

Incompetence = neurologically unable to close velopharyngeal valve 

Outflow tract blockage or narrowed 

Affect on Speech 

Hypernasal  

Facial grimace when speaking 

Hyponasal  

(such as when speaking with pinching your nose)

Speech Compensation 

Consonant omission 

Glottal stops 

 

Evaluation 

 

Sleep study (polysomnography) if concern for OSA 

Treatment 

 

Criteria to treat: 

Interference with speech that prevents normal interactions 

OSA