How To Repair A Soft Palate That Doesn't Close When Talking

Velopharyngeal Insufficiency

Velopharyngeal insufficiency (VPI) is the result of an improper closing of the velopharyngeal sphincter, the soft palate musculus, during oral communication. When this muscle does not close properly, air escapes through the nose instead of the mouth. During speech, VPI produces a nasal quality to the vocalization, known equally hypernasality, and a snorting sound during the pronunciation of certain letters. The status is normally diagnosed in children, although it may be diagnosed in older patients from developing countries where early on diagnosis and treatment have not been available.

Causes of Velopharyngeal Insufficiency

Velopharyngeal insufficiency may exist caused by a number of conditions, including:

• Crack palate
• Tonsil or adenoid surgery
• Nerve or musculus disease
• Weak throat muscles
• Traumatic brain injury

Almost one third of children who take surgery for cleft palate will too have persistent VPI after their palate repair. VPI may also develop afterward an adenoidectomy, a surgical process to remove adenoids or tissue in the back of the nose.

Diagnosis of Velopharyngeal Insufficiency

The hypernasal speech impediment is the primary symptom of VPI. Patients exhibiting the voice communication patterns associated with VPI must be examined by both a speech communication pathologist and an otolaryngologist for accurate diagnosis. The speech pathologist will analyze spoken communication sounds and patterns and the otolaryngologist will assess whatever structural abnormalities.

Various diagnostic tests are performed past the otolaryngologist to evaluate the precise cause of the VPI and to find the nature and location of any anatomical abnormalities. The physician will normally perform a nasopharyngoscopy, inserting a sparse flexible tube fitted with a tiny cobweb optic camera through the nose. This will enable to dr. to see the back of the throat where the velopharyngeal muscles are attempting to close. The physician may also perform a videofluoroscopy of the palate and throat during speech. This test is administered subsequently the patient has been given opaque barium nose drops to illuminate the targeted area. Another exam usually administered to patients with VPI is nasometry, which measures the output of air from the olfactory organ and oral cavity during voice communication. Sometimes an MRI scan of the the palate and throat muscles is as well conducted.

Treatment of Velopharyngeal Insufficiency

Most patients can fully recovery from velopharyngeal insufficiency through a combination of surgical and nonsurgical treatments. Nonsurgical treatments for VPI include spoken language therapy and the utilize of an obturator, a modified dental retainer which alters the position of a weak palate.

Surgical methods used for treating VPI include:

• Pharyngeal flap procedure
• Pharyngoplasty
• Furlow palatoplasty
• Augmentation pharyngoplasty
• Velopharyngeal sphincter reconstruction

After surgery, speech communication therapy is often necessary to modify speech patterns acquired prior to the procedure.

Additional Resource

• MedlinePlus
• National Institutes of Health
• Centers for Affliction Command and Prevention
• Eunice Kennedy Shriver National Institute of Child Health and Human Evolution
• U.S. Department of Health & Human Services
• U.S. National Library of Medicine
• WebMD

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Source: https://www.jgoldbergmd.com/velopharyngeal-insufficiency.php

Posted by: shusterstrel1997.blogspot.com

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