title: A review of the evaluation and management of velopharyngeal insufficiency in children.
abstract: This article highlights the most common causes of velopharyngeal insufficiency (VPI), and discusses routine evaluation and treatment algorithms for the management of VPI in children. VPI is a multifactorial condition that occurs commonly in syndromic and non-syndromic children. The most common features of VPI are audible hypernasal speech, facial grimacing, decreased speech intelligibility, nasal regurgitation, and nasal emission from failure to produce oronasal separation. Work-up of VPI typically involves radiologic and endoscopic testing performed with the assistance of a speech-language pathologist. Management of VPI involves initial speech therapy followed by operative repair with sphincter or pharyngeal flap pharyngoplasty, if needed.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, 170 Manning Drive, Chapel Hill, NC 27599-7070, USA. ruda@med.unc.edu
authors.forename: James M
authors.initials: JM
authors.lastname: Ruda
authors.forename: Paul
authors.initials: P
authors.lastname: Krakovitz
authors.forename: Austin S
authors.initials: AS
authors.lastname: Rose
mesh_terms: D002508:Cephalometry; D002648:Child; D002972:Cleft Palate / Q000150:complications; D004062:DiGeorge Syndrome / Q000150:complications; D004724:Endoscopy; D005471:Fluoroscopy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008487:Medical History Taking; D020331:Mobius Syndrome / Q000150:complications; D009136:Muscular Dystrophies / Q000150:complications; D009157:Myasthenia Gravis / Q000150:complications; D009296:Nasal Cavity; D009422:Nervous System Diseases / Q000150:complications; D013517:Otorhinolaryngologic Surgical Procedures; D010156:Palatal Muscles / Q000473:pathology / Q000503:physiopathology; D010160:Palate, Soft / Q000002:abnormalities / Q000473:pathology / Q000503:physiopathology; D010808:Physical Examination; D013060:Speech; D013068:Speech Production Measurement; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D014741:Video Recording