Elsevier

American Journal of Otolaryngology

Volume 18, Issue 1, January–February 1997, Pages 38-46
American Journal of Otolaryngology

Original contribution
Identification and assessment of velopharyngeal inadequacy

https://doi.org/10.1016/S0196-0709(97)90047-8Get rights and content

Abstract

Purpose: To review current literature with respect to the diagnosis and assessment of velopharyngeal inadequacy (VPI), including present knowledge about the most common causes of VPI.

Methods: Data sources include published reports over the past 20 years derived from computerized databases and bibliographies of pertinent articles and books. Indexing terms used were “velopharyngeal incompetence,” “velopharyngeal inadequacy,” “velopharyngeal insufficiency.”

Conclusion: VPI is most commonly associated with cleft palate, submucous cleft palate, and following adenoidectomy. The otolaryngologist can prevent the latter by preoperative identification of physical stigmata associated with VPI. Perceptual assessment is the criterion standard for diagnosis of VPI. Multiview videofluorography and flexible nasal endoscopy provide the best direct assessments to help plan and direct the optimal treatment of VPI.

References (85)

  • J. Trost

    Articulatory additions to the classical description of the speech of persons with cleft palate

    Cleft Palate J

    (1981)
  • R.T. Minami et al.

    Velopharyngeal incompetence without overt cleft palate

    Plast Reconstr Surg

    (1975)
  • E.N. Kaplan

    The occult submucous cleft palate

    Cleft Palate J

    (1975)
  • W.C. Trier

    Velopharyngeal incompetency in the absence of overt cleft palate: Anatomic and surgical considerations

    Cleft Palate J

    (1983)
  • M.L. Lewin et al.

    Velopharyngeal insufficiency due to hypoplasia of the musculus uvulae and occult submucous cleft palate

    Plast Reconstr Surg

    (1980)
  • J.G. McCarthy et al.

    Introduction to facial clefts

  • T.H. Ingalls et al.

    Cleft lip and cleft palate: Epidemiologic considerations

    Plast Reconstr Sung

    (1964)
  • W. Tünte

    Is there a secular increase in the incidence of cleft lip and palate?

    Cleft Palate J

    (1969)
  • S.J. Peterson-Falzone

    A cross-sectional analysis of speech results following palatal closure

  • H.L. Morris et al.

    Multidisciplinary treatment results for patients with isolated cleft palate

    Plast Reconstr Sung

    (1993)
  • N. Ainoda et al.

    Articulation at age 4 in children with early repair of cleft palate

    Ann Plast Surg

    (1985)
  • J. Bardach et al.

    Late results of primary veloplasty: The Marburg project

    Plast Reconstr Sung

    (1984)
  • D.S. Dorf et al.

    Early cleft palate repair and speech outcome

    Plast Reconstr Surg

    (1982)
  • G.N. Coston et al.

    Levator muscle reconstruction: Resulting velopharyngeal competence—A preliminary report

    Plast Reconstr Surg

    (1986)
  • T.M. Dreyer et al.

    A comparison of palatoplasty techniques

    Cleft Palate J

    (1984)
  • B. Holtmann et al.

    A comparison of three techniques of palatorrhaphy: Early speech results

    Ann Plast Surg

    (1984)
  • S.A. Schendel et al.

    Histochemical analysis of cleft palate muscle

    Plast Reconstr Surg

    (1994)
  • S.J. Peterson-Falzone

    Velopharyngeal inadequacy in the absence of overt cleft palate

    J Craniofac Genet Dev Biol

    (1985)
  • C.B. Croft et al.

    The occult submucous cleft palate and the musculus uvulae

    Cleft Palate J

    (1978)
  • N.W. Todd et al.

    Minuscule submucous cleft palate. Cadaver study

    Ann Otol Rhinol Laryngol

    (1992)
  • R.C.A. Weatherley-White et al.

    Submucous cleft palate. Its incidence, natural history, and indications for treatment

    Plast Reconstr Surg

    (1972)
  • M. Garcia-Velasco et al.

    Diagnosis and treatment of submucous cleft palate: A review of 108 cases

    Cleft Palate J

    (1988)
  • S.J. Peterson-Falzone

    Submucous clefts of the palate: How likely are they to be symptomatic?

    Cleft Palate Craniofac J

    (1991)
  • B.J. McWilliams

    Submucous clefts of the palate: How likely are they to be symptomatic?

    Cleft Palate Craniofac J

    (1991)
  • R.J. Shprintzen et al.

    Velopharyngeal insufficiency in the facioauriculo-vertebral complex

    Cleft Palate J

    (1980)
  • M.A. Pollack et al.

    Velopharyngeal insufficiency: The neurological perspective. A report of 32 cases

    Develop Med Child Neurol

    (1979)
  • B. Hillarp et al.

    Myotonic dystrophy revealed at videoradiography of deglutition and speech in adult patients with velopharyngeal insufficiency: Presentation of four cases

    Cleft Palate-Craniofac J

    (1994)
  • J.H. Robinson

    Association between adenoidectomy, velopharyngeal incompetence, and submucous cleft

    Cleft Palate-Craniofac J

    (1992)
  • R.M. Mason

    Preventing speech disorders following adenoidectomy by preoperative examination

    Clin Pediatr

    (1973)
  • C.B. Croft et al.

    Hypernasal speech following adenotonsillectomy

    Otolaryngol Head Neck Surgl

    (1981)
  • G. Osborne et al.

    Upper cervical spine anomalies and osseous nasopharyngeal depth

    J Speech Hear Res

    (1971)
  • K.T. Kavanagh et al.

    Risks and benefits of adenotonsillectomy for children with Down syndrome

    Am J Ment Defic

    (1986)
  • Cited by (0)

    View full text