Work-up of velopharyngeal insufficiency/open nasality

Velopharyngeal insufficiency involves insufficient closure between the oropharynx and nasopharynx. Food and drink may leak during swallowing, and speech may become nasal.

Velopharyngeal insufficiency may result from congenital conditions such as:

  • Cleft lip and palate or submucosal cleft palate.
  • Congenital paresis in the palatine muscles.
  • Dysfunction of the apparatus involved with articulation.

Velopharyngeal insufficiency may also be caused by CNS disease, such as stroke or neuromuscular disease.


In addition to medical history, a speech therapist will conduct a standardized speech assessment.

A phoniatrician will assess the ability to seal and dynamic function using fiberoptic video of the seal between the soft palate and the posterior pharyngeal wall.


Treatment of cleft lip and palate may involve speech therapy by a speech therapist and/or recommendation for surgery to improve speech. In conditions involving normal anatomy but palatine weakness, we sometimes design a palate-lifting device in collaboration with a dentist.

Page revised Wednesday, May 11, 2011

Content manager: Anders Westerborn

Published by Anita Pettersson