Speech surgery is performed for patients who have Velopharyngeal Insufficiency (VPI). In patients with VPI, too much air escapes from the nose during speech. This is typically evaluated with a speech nasal endoscopy, performed with a Pediatric Otolaryngologist and a Speech Pathologist. The first line of treatment is speech therapy, but if the patient has persistent problems, they may be a candidate for speech surgery.
Velopharyngeal Insufficiency (VPI)
Velopharyngeal Insufficiency (VPI) occurs when the palate and the back wall of the throat do not contact correctly. VPI results in too much air escape from the nose during speech. Parents may notice a rustle of air during speech or an inability to say high-pressured sounds, including b, p, t, s or sh. This speech pattern often occurs in patients who have had a cleft palate repair or have a diagnosis of 22q11, but it can also occur in isolation.
Evaluation of VPI is performed with and ENT and speech therapist working together. A small camera is placed in the patient’s nose and used to watch the palate motion during speech sounds. Our Pediatric Otolaryngologists work closely with experienced Speech Therapists at Advocate Children’s Hospital as well as with the Cleft and Craniofacial Team to provide full evaluations.
Treatment for VPI begins with speech therapy. Some children will require surgery to move some tissue in the back of the throat to allow the palate and throat to work better.
There are several different options for speech surgery, including posterior pharyngeal wall augmentation, dynamic sphincter pharyngoplasty, palatal lengthening, and pharyngeal flap. Talk to your surgeon about what procedure may benefit your child.
You can find more information on the Cleft Palate Foundation.
Microlaryngoscopy is a procedure performed in the Operating Room while under anesthesia. This allows a very careful inspection of the voice box and surrounding structures. Microlaryngoscopy is performed with magnified telescopes and allows for photographs and video, if necessary. We can also perform laser procedures or biopsies with this method.