Velopharyngeal Insufficiency in Childhood: Practical Guidelines for Everyday Pediatric Practice

Abstract

Velopharyngeal insufficiency (VPI) is a disorder of the closing mechanism between the nasopharynx and oropharynx, in which the soft tissues of the velum and pharyngeal walls fail to achieve adequate contact during speech, swallowing, and blowing. The condition is among the leading causes of hypernasal speech in childhood and carries significant consequences for communicative development and quality of life. This review systematizes current data on the etiology, pathophysiology, and clinical manifestations of VPI, with a focus on key indicators for its early recognition. Attention is given to the multidisciplinary approach, integrating the efforts of the pediatrician, otorhinolaryngologist, plastic surgeon, speech-language pathologist, orthodontist, and psychologist.

Key words: velopharyngeal insufficiency, hypernasality, cleft palate, velopharyngeal valve

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Address for correspondence:

Iglika Stancheva

Department of Otorhinolaryngology, Faculty of Medicine, Medical University of Sofia,
University Hospital “Tsaritsa Yoanna – ISUL”, Sofia

8, “Bialo more”, Str.

e-mail: iglika_stancheva@yahoo.com