Velopharyngeal Dysfunction Program :: Nationwide Children's Hospital

Velopharyngeal Dysfunction Program

The Velopharyngeal Dysfunction Program at Nationwide Children’s Hospital provides coordinated interdisciplinary diagnostic and treatment services for patients with speech disorders resulting from velopharyngeal dysfunction. It is the only program of its kind in central Ohio.

What is Velopharyngeal Dysfunction (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 typically exhibit hypernasal speech, abnormal articulation, and decreased intelligibility. Successful surgical management of VPD requires precision in diagnosis and individualization of treatment.

Signs and Symptoms of VPD may include:

  • Excessively nasal speech quality (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

Conditions commonly associated with Velopharyngeal Dysfunction

  • Cleft palate
  • Submucous cleft palate or bifid uvula
  • Congenital short soft palate  
  • 22q11.2 deletion syndrome (velocardiofacial/DiGeorge syndrome)
  • Neurofibromatosis Type I  
  • Hemifacial microsomia/Goldenhar syndrome  
  • Congenital neuromuscular diseases  
  • Congenital or acquired palatal weakness or paralysis
  • Hypernasal speech after adenoidectomy (persisting more than a few weeks post-surgery)


In most cases of VPD, speech therapy alone is typically not effective at treating hypernasal speech and velopharyngeal dysfunction, so surgical options such as a Pharyngeal flap or Sphincter pharyngoplasty may be recommended. Surgical management of VPD is highly effective and aims to normalize or improve resonance, improve intraoral pressure so speech sounds are “stronger” and louder, and to reduce the leakage of airflow through the nose during speech.  The anticipated results of speech surgery are speech that is both clearer to understand and more socially acceptable. Surgery is typically conducted by one of our expert Plastic Surgeons from the Cleft Lip and Palate Center, Dr. Richard Kirschner and Dr. Gregory Pearson, who have significant experience in VPD surgery.

Many children with VPD will also require intensive speech therapy in addition to speech surgery. Our team works closely with speech-language pathologists at Nationwide Children's to collaborate on treatment plans and therapy needs to ensure your child’s speech outcome will be optimized.

In rare cases, some individuals with velopharyngeal dysfunction may not be a surgical candidate, so a speech prosthesis may be an option to improve their speech. Our Resonance Disorders Team works closely with dental professionals (such as a prosthodontist) at Nationwide Children's and the OSU Department of Prosthodontics to have these specialized devices created.


Family-friendly booklet on treatment for resonance disorders (Cleft Palate Foundation)

Services available:

  • Genetic Evaluation and Testing
  • Speech Evaluation
  • Instrumental Speech Assessment
  • Diagnostic Imaging  
  • Speech Therapy
  • VPD Surgery

Clinics and Ambulatory Services:

Velopharyngeal Dysfunction Program
Outpatient Care Center, First Floor
555 S. 18th Street
Columbus, Ohio 43205

Cleft Lip and Palate Center
Outpatient Care Center, First Floor
555 S. 18th Street
Columbus, Ohio 43205

Center for Complex Craniofacial Disorders
Outpatient Care Center, First Floor
555 S. 18th Street
Columbus, Ohio 43205

The 22q Center
Nationwide Children’s Hospital
Outpatient Care Center, First Floor
555 South 18th Street
Columbus, Ohio 43025

Contact Numbers:

Local: (614) 722-6299
Fax: (614) 722-4000
Toll Free: (877) 722-6220

Contact- Velopharyngeal Dysfunction Program

VPD 2016 Symposium

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000