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Velopharyngeal insufficiency occurs when the soft palate—commonly known as the roof of the mouth—does not properly connect with the back of the throat while speaking or swallowing. This structural problem allows air to escape through the nose while speaking, causing nasal speech and problems with speech articulation.

Surgeons, speech therapists, and audiologists at Hassenfeld Children’s Hospital at ºÃÉ«tv Langone collaborate to offer your child a team-based and personalized approach to managing velopharyngeal insufficiency.

Advanced Tools for Diagnosis

Our experts offer a variety of advanced tools to examine and diagnose your child. They include the following:

• speech assessment, in which specialists in Speech–Language Pathology Services for Children listen for nasal sounds or the escape of air through the nose while your child is speaking
• nasometric exam, which uses a special tool to determine how the soft palate and back of throat are causing nasal speech
• nasopharyngoscopy, using a flexible tube with a camera on the end to view how the palate and the back of the throat move during speech

Child life specialists are available to provide comfort and support to your child during these tests.

Personalized Care Plans

Our doctors offer nonsurgical and surgical approaches to managing velopharyngeal insufficiency and consider the unique needs of your child when creating a care plan.

Some children may benefit from a speech appliance, which is like a dental retainer. A special attachment in the back of the appliance prevents air from escaping through the nose; this helps speech sound less nasal. Our speech–language pathologists assess how well it is working. This may be an option if you prefer that your child avoid or delay surgery.

Surgical options to address velopharyngeal insufficiency include:

• furlow palatoplasty, a procedure that lengthens the palate by moving muscles in the roof of the mouth to a more normal position
• sphincter pharyngoplasty, which moves tissue from the sides of the throat to create a mound of tissue at its back that the soft palate can meet while speaking
• pharyngeal flap surgery, which creates a bridge between the soft palate and the back of the throat

Our doctors and speech–language pathologists provide follow-up care after these procedures to ensure your child is healing properly and that speech has improved.