Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Velopharyngeal Insufficiency

By

Clarence T. Sasaki

, MD, Yale University School of Medicine

Last full review/revision Jan 2020| Content last modified Jan 2020
Click here for the Professional Version
Topic Resources

Velopharyngeal insufficiency is incomplete closure of the velopharyngeal sphincter between the oral and nasal cavities, causing a hypernasal voice.

The velopharyngeal sphincter (which includes the soft palate and the side and back walls of the throat) separates the oral and nasal cavities during swallowing and speech. During speech, air is directed through the mouth and not the nose. In velopharyngeal insufficiency, the seal is not complete, allowing air to leak through the nose causing a hypernasal resonant voice (sounding nasally).

Velopharyngeal insufficiency can occur in people born with splitting of the roof of the mouth (cleft palate) or a palate that is too short. It can sometimes develop after tonsil or adenoid surgery or as a result of muscle weakness in people with neurological disorders such as cerebral palsy, stroke, or brain tumors. Other causes include genetic syndromes such as neurofibromatosis and tumors in the palate.

Symptoms of velopharyngeal insufficiency include a hypernasal voice with an inability to form speech sounds correctly. Severe velopharyngeal insufficiency can cause solid foods and fluids to regurgitate through the nose.

Doctors suspect velopharyngeal insufficiency in people with the typical speech abnormalities. To confirm the diagnosis, doctors inspect the velopharyngeal sphincter with a fiberoptic nasoendoscope (a flexible tube passed through the nose) or x-rays taken while swallowing different foods (videofluroscopy).

Treatment is with speech therapy and sometimes with a special device worn in the mouth or surgery.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version

Test your knowledge

Loss of Smell
Anosmia is the total loss of smell. Most people with anosmia can taste sweet, sour, salty, and bitter substances but cannot distinguish among specific flavors. This is because the sense of smell makes it possible to distinguish among flavors, not taste receptors as many people erroneously believe. Which of the following is NOT a common cause of anosmia?
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID

Also of Interest

Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
TOP