Velopharyngeal insufficiency (VPI)

Velopharyngeal insufficiency (VPI) happens when the velum (the soft palate) and nearby parts of the mouth can't close itself to the nasopharynx. The nasopharynx separates the oral and nasal cavities. You use it to make the sounds of consonants when you speak.

Several things can cause VPI. Most are due to a physical defect. Sometimes there may be a "functional" problem that includes misuse of the velum. VPI may also be the result of an obstruction of the nasopharynx, including enlarged adenoids or a narrow or damaged nasopharynx. The most common cause of VPI is cleft palate with or without cleft lip.

Unlike other speech problems, VPI often happens because of a structural problem in the palate or throat. We can't fix these problems with speech therapy alone.

At Children's Hospital's VPI program, we create a care plan designed for your child, which may include speech therapy or surgery.

During your first visit, you and your child will meet with an ENT doctor (otolaryngologist) and a speech pathologist. They will evaluate your child’s speech and tone. The team may also examine your child’s nose and throat using a child-sized endoscope, a thin, flexible tube attached to a bright light and a camera to determine speech problems.