부산대학교 도서관

This chapter explores velopharyngeal dysfunction (VPD), its impact, aetiology, assessment, and management. VPD may cause hypernasal, weak, and unintelligible speech, facial grimacing, nasal turbulence and nasal regurgitation, middle ear problems, and sinusitis. Such manifestations may be distressing for the patient, be associated with poor academic outcomes, be negatively perceived by others, lead to bullying and withdrawal, and result in relationship and employment difficulties. Like the effect of a visible difference on psychosocial confidence and self-esteem, the manifestations of VPD on emotional well-being and social interaction do not necessarily correlate with the amount of speech, language, or communication dysfunction. Normal anatomy, neuromotor function, and speech learning are prerequisites for effective velopharyngeal function. A problem with any of these components may result in a velopharyngeal mechanism that fails to efficiently and fully close throughout oral speech sound formation leading to VPD and an ensuing speech disorder. Perceptual speech evaluation is used to diagnose VPD. Lateral videofluoroscopy and nasoendoscopy are commonly deployed to assess velopharyngeal function and determine management strategies. Surgical interventions include pharyngoplasty, pharyngeal flaps, and velopharyngeal augmentation. Non-surgical interventions include speech prostheses and nasal obturators for speech improvement.