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Last update 08 May 2025

Velopharyngeal Insufficiency

Last update 08 May 2025

Basic Info

Synonyms

Inadequate Velopharyngeal Closure, Incompetence, Palatopharyngeal, Incompetence, Velopharyngeal

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Introduction

Failure of the SOFT PALATE to reach the posterior pharyngeal wall to close the opening between the oral and nasal cavities. Incomplete velopharyngeal closure is primarily related to surgeries (ADENOIDECTOMY; CLEFT PALATE) or an incompetent PALATOPHARYNGEAL SPHINCTER. It is characterized by hypernasal speech.

Clinical Trials associated with Velopharyngeal Insufficiency

NCT05492266

/ RecruitingNot ApplicableIIT

Expiratory Muscle Strength Training As a Non-surgical Option for Velopharyngeal Dysfunction: a Randomized-controlled Trial

When the soft palate does not move enough because of a cleft palate or for unknown reasons, this can lead to a speech difference called velopharyngeal insufficiency. The purpose of this research study is to test if soft palate exercises using a hand help breathing device will help improve the ability of the soft palate to close the area between the throat and nose and help improve speech.

Start Date01 Mar 2025

Sponsor / Collaborator

University of Pittsburgh

[+1]

NL-OMON57175

/ SuspendedNot ApplicableIIT

Velopharyngeal insufficiency after maxillomandibular advancement in obstructive sleep apnea patients - Velopharyngeal insufficiency after maxillomandibular advancment

Start Date01 Jan 2025

Sponsor / Collaborator-

NL-OMON56871

/ SuspendedNot Applicable

The use of MRI-scans to assess velopharyngeal insufficiency in cleft palate patients - The use of MRI-scans to assess VPI

Start Date02 Sep 2024

Sponsor / Collaborator

Amsterdam University Medical Center

100 Clinical Results associated with Velopharyngeal Insufficiency

100 Translational Medicine associated with Velopharyngeal Insufficiency

0 Patents (Medical) associated with Velopharyngeal Insufficiency

2,438

Literatures (Medical) associated with Velopharyngeal Insufficiency

01 Sep 2025·Journal of Stomatology, Oral and Maxillofacial Surgery

Construction of virtual airway model to assist surgical correction of velopharyngeal insufficiency with posterior pharyngeal flap

Article

Author: Lanrui, Luo ; Zhigang, Cai ; Shuang, Yang ; Hongping, Zhu ; Hongping, Zhu ; Zhigang, Cai ; Changjiang, Du ; Xia, Zhou

OBJECTIVEPosterior pharyngeal flap (PPF) is one of the most common surgical technique to correct velopharyngeal insufficiency(VPI), during which controlling the sizes of the lateral pharyngeal ports(LPP) is the key to outcomes. One innovative procedure was developed to well control the size of LPP.MATERIALS AND METHODS40 patients with repaired cleft palate were collected from June 2022 to August 2023. All patients were diagnosed with VPI, and treated with modified PPF surgery. For each patient, upper airway model was reconstructed, and the virtual airway model of PPF was designed. The nasal valve area was measured as it was considered to be the narrowest part of the upper airway. The upper airway resistances under different sizes of LPP was predicted through computational fluid dynamics analysis. The minimum size of each lateral pharyngeal port without obviously increase of upper airway resistance was calculated through effect of lateral pharyngeal ports' size on upper airway resistance. Postoperative follow-up was 6-18 months, including speech outcome and respiration outcome. Resting soft palate length (RVL), effective working length of soft palate (EWL) and angle of soft palate elevation (AVL) were measured and compared according to the lateral cephalometric radiograph.RESULTSThere was a linear relationship between the threshold value and nasal valve (R = 0.62). Among the forty patients, the average size of nasal valve was 47.81 mm², the average size of the threshold value of LPP was 31.63mm². The proportion of velopharyngeal closure competence after surgery was 95 %. Compared with the preoperative measurements, there were significantly increase of RVL, EWL and AVL (P < 0.05). There were significantly difference in the nasal obstruction symptom evaluation score in long-term follow-up compared to short-term follow-up (P < 0.05), and no one needed flap revision. There was no significant difference in nasal respiration and nasal resistance before and after surgery (P > 0.05).CONCLUSIONWith the help of computer fluid dynamics analysis, it is possible to predict the threshold size of lateral pharyngeal port without obviously increasing upper airway resistance and reduce the risk of suffering from airway obstruction for patients undergoing PPF surgery.

01 Jun 2025·Auris Nasus Larynx

Speech-swallow dissociation in velopharyngeal closure for differentiating amyotrophic lateral sclerosis and myasthenia gravis

Article

Author: Yaguchi, Hiroshi ; Sakuta, Kenichi ; Miyagawa, Shinji ; Yamamoto, Sumire ; Nakada, Ryoji

OBJECTIVESpeech-swallow dissociation (SSD) in velopharyngeal closure on laryngoscopy is a sign of pseudobulbar palsy. We hypothesized that this finding could differentiate amyotrophic lateral sclerosis (ALS) from myasthenia gravis (MG). This study aimed to identify laryngoscopic findings useful in differentiating these two diseases.METHODSALS and MG patients with bulbar symptoms who underwent fiberoptic laryngoscopy in our hospital were retrospectively examined. The following laryngoscopic items were evaluated: velopharyngeal incompetence (VPI) in phonation and swallowing, pharyngeal constriction, vocal cord movement, and salivary status.RESULTSOne hundred seven patients (70 with ALS and 37 with MG) were included for analysis. The prevalence of VPI in phonation was significantly higher in the ALS group (40 % vs. 19 %; P = 0.027). The prevalence of SSD in velopharyngeal closure was also significantly higher in the ALS group (33 % vs. 3 %; P < 0.001). The other laryngoscopic findings did not differ between the groups. Multivariate logistic regression showed that SSD in velopharyngeal closure was independently associated with ALS (odds ratio, 26.64; 95 % confidence interval, 2.24-317.58; P = 0.009).CONCLUSIONSSD in velopharyngeal closure is useful for differentiating ALS from MG.

01 Jun 2025·International Journal of Pediatric Otorhinolaryngology

Postoperative caregiver decision regret following velopharyngeal dysfunction surgery

Article

Author: Tracy, Meghan ; Nallani, Rohit ; Farrokhian, Nathan ; Arganbright, Jill ; Sykes, Kevin J

BACKGROUNDDecision regret (DR) is a powerful factor in medical decision-making, particularly for surgical decisions which carry multiple risks, impact quality of life (QOL), and have uncertain outcomes. While prior studies have investigated caregiver DR after tonsillectomy and otologic surgery, there is a paucity of data assessing DR following pediatric otolaryngology procedures. The aim of this study is to measure DR following velopharyngeal dysfunction (VPD) surgery.METHODSA cross-sectional survey study with chart review was performed of caregivers of children who had VPD surgery performed by a single surgeon at a tertiary children's hospital. Demographic, medical, and surgical history were collected. Surveys assessed postoperative DR (scale 0-100), satisfaction with surgery (0-10), caregiver engagement in decision making, and QOL using the VPI Effects on Life Outcomes (VELO)-parent instrument (0-100).RESULTSOf 59 caregivers who received the survey, 27 (45.8 %) completed the surveys. Caregivers felt involved in the decision for surgery (85 %). Postoperative caregiver-reported QOL (mean 81.5) and satisfaction (mean 9.4) were overall high. DR was low (mean 4.4), with 22 caregivers (78.6 %) reporting zero DR. Compared to those with no regret, those with DR > 0 reported lower satisfaction (mean 9.7 vs 8.0, p = 0.002) and worse speech limitations (mean 81.2 vs 67.1, p = 0.015) or situational difficulty (mean 77.7 vs. 51.0, p < 0.001) on VELO subscales.CONCLUSIONWhile DR was overall low following VPD surgery, presence of DR was associated with worse speech-related QOL. Further prospective and multi-institutional study of DR is needed in pediatric otolaryngology to identify predictors of regret and understand treatment outcomes.

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