Velopharyngeal Dysfunction (VPD)

What is VPD?

Velopharyngeal dysfunction (VPD) is the inadequate separation of the oral and nasal cavities during speech and/or swallowing. VPD is caused by structural and/or functional abnormalities of the soft palate and pharyngeal muscles. Patients with VPD often exhibit hypernasal speech, abnormal articulation, and decreased intelligibility. Successful surgical management of VPD requires precision in diagnosis and individualization of treatment.

What Causes VPD?

Most children with VPD also have articulation difficulties and may be difficult to understand. The cause of VPD varies, but is most commonly due to:

  • A short soft palate

  • Submucous cleft palate

  • Abnormalities of the palate or throat

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What are the Signs and Symptoms of VPD?

Signs and symptoms of VPD may include:

  • Excessively nasal speech quality (also known as hypernasality)
  • Leakage of air through the nose while speaking
  • Speech which sounds weak or muffled
  • Abnormal articulation
  • Leakage of food or liquid through the nose while eating

How is VPD Diagnosed?

If VPD is suspected at any age, a referral should be made to a specialized VPD Team or to a cleft lip and palate team for proper diagnosis and management.

Children with VPD who also have other medical conditions (e.g., heart abnormalities) or learning difficulties often require evaluation by a geneticist to determine if there is an identifiable genetic cause of their VPD.

The most common genetic cause of VPD is a condition known as 22q11.2 deletion syndrome. Children with 22q11.2 deletion syndrome benefit from a comprehensive evaluation by a team of expert professionals to ensure development of the safest and most effective treatment plan for their VPD.

How is VPD Treated?

Treatment may include surgery to repair the palatal abnormality and to help direct sound and air away from the nose and back into the mouth during speech. In some cases, speech therapy is recommended to target articulation skills.

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