Velopharyngeal Dysfunction

Treatments

Treatment for velopharyngeal dysfunction is determined following an evaluation by a specially trained speech pathologist who can differentiate what roles speech therapy and/or surgery play in treatment. Treatment may include:

• Surgery. If velopharyngeal dysfunction is due to a structural issue, the resulting speech issues will not resolve without surgical intervention. Most cases of velopharyngeal dysfunction require surgery to correct hypernasal speech or excessive air leakage out of the nose while talking. A surgeon, with the help of a speech pathologist who specializes in velopharyngeal dysfunction, determines whether your child is a candidate for a surgical procedure. If so, the type of surgery is tailored to your child's specific needs based on the results of the nasopharyngoscopy. Medical factors are also taken into consideration, such as diagnosis, previous treatment course and history of apnea or airway obstruction. Potential surgeries include a pharyngeal flap, sphincter pharyngoplasty, Furlow Z-plasty and fat injections. If surgery is required, a one- to two-night stay at the hospital is typical depending on the age of your child. He or she will likely be on a six-week diet restriction. Some symptoms may resolve immediately, but sometimes “typical” speech can take months to years to develop.
• Speech therapy. Speech therapy teaches correct placement of sounds, how to use the tongue, teeth and lips to make sounds and how to direct airflow out of the mouth correctly during speech production. Articulation errors related to velopharyngeal dysfunction can, at times, be difficult to treat and are easier to prevent. This is why monitoring by a cleft and craniofacial team is important. The duration of therapy varies for each child and can range from months to years. Your child’s speech pathologist will clarify which aspects of speech should improve with surgery and which should improve with speech therapy.