Velopharyngeal insufficiency (VPI) describes a group of communication disorders that create a resonance disturbance during speech. This includes velopharyngeal incompetence, which is a neurogenic disorder; and velopharyngeal mislearning, which is a functional disorder that comes from one of a few structural abnormalities that occur in the region of the face.
VPIs are most often associated with babies who are born with some degree of cleft palate, a birth defect that halts the complete formation of the hard and soft palate of the maxillary (upper) jaw. Cleft palate repair can call for multiple surgical procedures, and a team of surgeons may be consulted for this process. Treatment often includes the help of a head and neck surgeon; ear, nose and throat physician; plastic surgeon and oral surgeon.
Velopharyngeal insufficiency may be identified even after cleft palate repair, as well. For this reason, consider an assessment to receive an accurate diagnosis. The VPI may cause a hyper nasal sound in the speech patterns of the child, in which case speech therapy will also become beneficial as he or she grows. Family counseling may also be necessary to ensure communication remains a healthy aspect of your household despite this challenging disorder.
Further treatment may be preferred depending on the severity; just remember that the ability to get a better fit between the soft palate and nasal area requires additional surgery after the repair of the cleft palate. For example, as described by the Cleft Palate-Craniofacial Journal, the area may need grafts with transplanted fat from another part of the body to treat the insufficiency. These procedures may be performed by plastic surgeons or oral surgeons.
The dental team
Especially with dental issues secondary to cleft palate, your child's pediatric dentist may recommend an evaluation by oral health professionals who specialize in related forms of treatment. Many times, orthodontia is required to improve the bite and put the maxillary anterior teeth into a better cosmetic position. Bone grafts may also be performed in the area of the cleft in the anterior maxillary ridge of the mouth. An oral surgeon will usually perform this grafting and work in coordination with the orthodontist, both of whom are sure to remind you to use products such as Colgate® Kids Cavity Protection toothpaste just the same when the primary teeth come in.
Of course, if the VPI is not associated with a cleft palate and there is a concern over speech ability, a thorough speech and dental assessment should be performed. Rest assured the medical team is aware that this problem is a threat to quality of life, and so they continue to research new and improved solutions for the good of youth development.