Current management of velopharyngeal insufficiency in children

Velopharyngeal insufficiency is a challenging problem with audible stigmata that can hinder child development and social achievement. The speech abnormalities resulting from velopharyngeal insufficiency can range from mild hypernasality to profound misarticulation. Speech evaluation by a trained speech therapist and direct visualization of velopharyngeal closure by nasopharyngoscopy provide the best assessment of velopharyngeal function. Current treatment options include speech therapy, use of a prosthetic obturator, and surgical intervention. Successful treatment depends on accurate diagnosis of the underlying defect and accurate evaluation of the specific effect on velopharyngeal closure.