Velopharyngeal Incompetence

The passage between the back of the nose and the mouth is called the “velopharyngeal port.” This port is required to open and close fully in rapid sequence for proper speech production. In some cases after cleft palate repair, the port closes insufficiently despite the proper Speech Therapy. In this case, your childs speech will have a heavy nasal quality and you may hear unusual air escape from the nose during speech. Your child may also have trouble blowing bubbles, inflating balloons or playing wind instruments.​

Surgery for Velopharyngeal Incompetence

Our team will carefully evaluate your child’s Velopharyngeal Mechanism by clinical exam, Nasoendoscopy or Palatogram. We will then recommend one of several procedures. Options include Furlow Palatoplasty, Pharyngeal Flap, or Sphyncter Pharyngoplasty. All these options tend to narror the nasal passage and may precipitate Obstructive Sleep Apnea. Usually, this improves spontaneously after about 6 weeks – when healing and scarring have finalized.

Post Operative Care

We recomend a liquid diet that includes liquid foods, such as soup, yogurt, pudding, ice cream, etc. for the first 5 days. This should be followed by 2 weeks of soft foods – nothing hard, dry or chewy. Speech therapy is restarted after 3 weeks. Snoring and Obstructive Sleep Apnea are expected to improve after 6 weeks. If they are still present 4–6 months later, a Polysomnogram or Sleep Study is performed. In only 10% of cases, a revision to tighten or loosen the port is required.