Velopharyngeal Dysfunction Differential Diagnoses

Updated: Mar 26, 2018
  • Author: Luke J Schloegel, MD; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
  • Print

Diagnostic Considerations

If a patient is presenting with speech delay, articulation problems, hypernasality, or nasal regurgitation, it is important to differentiate between a primary articulation problem and one related to either functional or anatomic velpharyngeal dysfunction (VPD). Patients with primary articulation disorders are treated with speech therapy alone.

In patients found to have VPD, a careful approach should be used to localize the cause, as discussed above, of the dysfunction. This helps to tailor the appropriate intervention. For example, if velopharyngeal closure is hindered by enlarged tonsils, tonsillectomy may actually improve the voice. If the problem is a velopharyngeal gap, then a surgical intervention can be selected to address the specific defect.