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Velopharyngeal Dysfunction $100.00
Authors:  Mosaad Abdel-Aziz, Mona Hegazi and Hassan Ghandour
Abstract:
The velopharyngeal port is the area bounded by the soft palate, the posterior pharyngeal wall and the lateral pharyngeal walls. Insufficient closure of this port will lead to leakage of air during speech (with the acoustic consequence of hypernasality) and leakage of fluids during swallowing (nasal regurgitation); a problem that is called velopharyngeal dysfunction (VPD). Its causes may be congenital or acquired. Overt cleft palate - even after its repair - is the commonest cause. Submucous cleft palate, neuromuscular disorders of the palate, palatal fistula are other causes. Post-operative VPD may occur following adenoidectomy, palatopharyngoplasty for sleep apnea and maxillary advancement. However, the cause may sometimes be unknown. Management of this problem is rather complex and requires a teamwork approach. Members of the team share in primary evaluation, planning of treatment and following up the results of intervention. At least, an otolaryngologist, a phoniatrician/speech language pathologist, and prosthetist should work together during management. Treatment decisions must be based, not only on subjective practitioner‘s impression, but also on data provided by some clinical diagnostic tools, such as nasopharyngoscopy, and videofluoroscopy. The treatment approaches may be non-surgical in the form of speech therapy or prosthetics, and/or surgical in the form of palatal surgery (e.g. Z-plasty or intravelar veloplasty) or pharyngeal surgery (e.g. pharyngoplasty, pharyngeal flap or posterior pharyngeal wall augmentation). 


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Velopharyngeal Dysfunction