Velopharyngeal Insufficiency Diagnosis
To diagnose VPI, a speech language pathologist will assess your child’s speech.
Your child will also see an otolaryngologist (ear, nose and throat specialist) for an exam. This doctor will insert a flexible fiber optic tube into your child’s nose to see the back of their throat where their velopharyngeal muscles are attempting to close. This is called nasopharyngoscopy.
When figuring out whether your child has VPI, it is just as important to find out if your child has difficulties with articulation (the way they make sounds), speech coordination (putting the sounds together) and voice (producing a sound from the voice box or larynx).
1. Speech therapy
Some speech problems linked with VPI, such as mispronouncing words, can be treated by speech therapy.
Treatment focuses on teaching the child the correct manner and place of articulation. In most cases, VPI speech symptoms cannot be decreased solely by speech treatment.
The Furlow palatoplasty is designed to bring the abnormally positioned muscles of the palate into a more normal position so the palate can move better.
When doing a sphincter pharyngoplasty , the surgeon moves tissue from the back of the throat closer to the back of the palate.
A sphincter pharyngoplasty surgery is recommended when the surgeon decides that the palate is working as well as it can, but the back of the throat isn’t moving correctly so the sides of the complex are used to fill the gap.
Sometimes a child will have minimal movement of the palate or the throat and may require both of these surgeries to be done at the same time.
Some patients who have surgery will still have VPI and may require additional surgery.