Types and Causes of Velopharyngeal Dysfunction

Abstract

The velopharyngeal valve is responsible for production of oral speech sounds. There are three components to normal velopharyngeal function: anatomy, physiology, and learning. velopharyngeal dysfunction (VPD) is a condition where the velopharyngeal valve does not close consistently and completely during the production of oral sounds. Velopharyngeal dysfunction can be caused by abnormal anatomy (velopharyngeal insufficiency), abnormal neurophysiology (velopharyngeal incompetence), or particular articulation errors (velopharyngeal mislearning). The purpose of this article is to acquaint the reader with what is required for normal velopharyngeal function. In addition, there will be a discussion of the types of velopharyngeal dysfunction and various causes of each. Implications for treatment and prognosis will be discussed.

Non-cleft causes of velopharyngeal dysfunction: Implications for treatment

“…Velopharyngeal dysfunction (VPD) is a condition where the velopharyngeal valve does not function normally in order to close consistently and completely during the production of oral sounds [1][2][3][4][5][6][7][8][9]. VPD is used as a general term that includes all disorders (with various causes) that affect closure of the velopharyngeal valve.…”

“…This is because different types of VPD require different treatment and result in a different prognosis [3,4,10,11]. The categories of velopharyngeal dysfunction and causes of each are summarized in Table 1.…”

“…The reason is that the treatment and the prognosis are different for these different categories of velopharyngeal dysfunction. Therefore, differential diagnosis by a speech-language pathologist is very important so that the patient receives the appropriate treatment [3,4,11,68].…”

Effects of spectral content on Horii Oral-Nasal Coupling scores in children

“…Speech that is perceived as excessively nasalized-i.e., hypernasal-can arise when a speaker suffers from articulatory mislearning, anatomical irregularities, or a neurological disorder that results in abnormal amounts of resonant energy in the nasal cavity while speaking, especially during vowel production (Kummer, 2011a,b). Some populations are prone to hypernasality of speech, particularly individuals with hearing impairment (due to the changes or outright lack of in feedback regarding their speech productions; Stevens et al, 1976;Kummer, 2011b) and individuals with a history of cleft palate (Kummer, 2011a). Speaking in a hypernasal manner may draw negative attention to the speaker and can have detrimental social consequences even during childhood (Blood and Hyman, 1977).…”

Sensory Innervation of the Human Soft Palate

“…The tongue and the soft palate are two key structures causing repetitive UA obstruction and breathing interference during sleep (Morrison et al, 1993;Lindman and Stål, 2002). The soft palate has been drawing increased attention due to its involvement with OSA (Demin et al, 2002;Rama et al, 2002;Kummer, 2011;Lee et al, 2012). Notably, soft palate sensory neuropathy might be involved in the pathologic progression often seen in OSA (Sunnergren et al, 2011).…”