Strategies for classifying and treating articulation disorders in patients with cleft palate are presented. [ncbi.nlm.nih.gov]

• Pathologist

  Typically a speech and language pathologist will evaluate a person’s speech pattern to determine the abnormal speech. [houstoncraniofacial.com]

  Prosthetic management of palatopharyngeal insufficiency requires a close co-operation between an otolaryngologist and a speech pathologist. [ncbi.nlm.nih.gov]

  The craniofacial speech pathologist will identify these areas and make appropriate recommendations for speech therapy and further evaluation. [lsuhscshreveport.edu]

• Cerebral Palsy

  Dysarthria (central or peripheral nerve damage) Cerebral palsy, myasthenia gravis, myotonic dystrophy, neurofibromatosis, cerebral or brainstem tumors Cranial nerve damage (IX, X, XII) causing isolated weakness of velum or pharyngeal muscles 4. [ucs.louisiana.edu]

  Cerebral palsy and traumatic brain injury are examples of disorders that cause velopharyngeal incompetence. Velopharyngeal Mislearning Velopharyngeal mislearning is when the child makes sounds in the pharynx, rather than in the mouth. [cincinnatichildrens.org]

  palsies, injuries to the soft palate, and cleft palate. [synapse.koreamed.org]

• Pain

  CONCLUSION: The modified de-mucosalized, superiorly based pharyngeal flap technique ensured self-mucosal draping of the bed, thus it would enhance primary healing and decrease postoperative pain with the resultant early ambulation. [ncbi.nlm.nih.gov]

  When it does occur, it may be due to unconscious "protecting" of the velopharyngeal mechanism from the postoperative pain. This abnormal pattern may disappear after 4-6 weeks, but it can persist as a habit, requiring speech therapy. [speechpathology.com]

  Ted, A Cpap will save you a lot of pain in the nuts. I have used one for years and it is a Godsend. I own two. One for home and one for travel. Seriously, save your jewels and get a sleep study. That goes for the rest of you, too. [trumpetmaster.com]

• Trisomy 21

  A predisposition to VPD is also present in patients with trisomy 21 (ie, Down syndrome). [emedicine.medscape.com]

  The most common chromosomal syndrome is Down syndrome or Trisomy 21, followed by Velocardiofacial syndrome or 22q11.2 Deletion Syndrome [ 2 ]. [omicsgroup.org]

• Fever

  In December 2009 I was tested and confirmed to have glandular fever, and from there is when things started goin Answer The velopharyngeal valve consists of the velum (soft palate) and pharyngeal walls (walls of the throat). [speechpathology.com]

• Pharyngitis

  […] augmentation have been credited with some improvement in VPI, secondary pharyngeal procedures, pharyngeal flap or sphincterpharyngoplasty remain the mainstay treatments for VPI. [journals.lww.com]

  Various treatment options in the literature include observation, speech and language pathology referral for pharyngeal strengthening, lipoinjection of the soft palate, and more invasive options, such as sphincter pharyngoplasty, pharyngeal flaps and V-Y [ncbi.nlm.nih.gov]

  Poor lateral pharyngeal wall movement 3. [ucs.louisiana.edu]

• Drooping Soft Palate

  […] provide myofunctional therapeutic advantages, the patient acceptance, especially those having long standing drooped soft palate, is usually low. [synapse.koreamed.org]

• Common Cold

  Nasal Congestion or Obstruction During Pregnancy Nasal Congestion Affected By How Well the Nose is Able to Cool Itself Nasal Surgery Helps With Snoring "Mother's Kiss" to Remove Nasal Foreign Bodies Treatment of Cough in Kids with the Common Cold Why [fauquierent.net]

• Dental Caries

  Uncontrolled dental caries: The edentulous condition itself is not a contraindication for a speech aid prosthesis. [j-ips.org]

• Tooth Loss

  […] syndrome Vertical root fracture Occlusal Tooth loss Edentulism Tooth wear Abrasion Abfraction Acid erosion Attrition Periodontium ( gingiva, periodontal ligament, cementum, alveolus ) – Gums and tooth-supporting structures Cementicle Cementoblastoma [en.wikipedia.org]

• Hearing Impairment

  Patient gave a history of hearing impairment for which he had consulted an otolaryngologist, and was diagnosed as a case of cleft palate which was subsequently corrected surgically eighteen years ago. [synapse.koreamed.org]

  It may be the result of phoneme-specific nasal emission and deafness or hearing impairment. [emedicine.medscape.com]

• Myopathy

  We hereby present our results following rhinopharyngeal autologous fat injection in 18 patients with mild velopharyngeal insufficiency (12 soft palate clefts, 4 functional VPI, 2 myopathy). 28 injections were carried out between 2004 and 2007. [link.springer.com]

• Suggestibility

  CONCLUSIONS: Our early experience suggests that calcium hydroxylapatite injection after failed sphincter pharyngoplasty is a safe, minimally invasive technique with favorable short-term results. [ncbi.nlm.nih.gov]

• Facial Grimacing

  All the study subjects were subjected to auditory perceptual speech evaluation for assessment of the degree of hypernasality, compensatory articulator mechanisms, glottal and pharyngeal articulation, audible nasal emission, facial grimace and overall [ncbi.nlm.nih.gov]

  Some people develop a change in their speaking pattern or a series of facial grimaces to try to overcome the difficulty. If the condition is acute, regurgitation through the nose may occur. [medical-dictionary.thefreedictionary.com]

• Pierre Robin Syndrome

  This is especially true in patients with Pierre Robin syndrome, in which retrognathia may result in upper airway obstruction. [emedicine.medscape.com]

  Airway hazards associated with pharyngeal flaps in patients who have the Pierre Robin syndrome. Plast Reconstr Surg 1976;58:184-6. 74. Kravath RE, Pollak CP, Borowiecki B, Weitzman ED. [jclpca.org]

• Speech Disorder

  It is characterized by hypernasal speech. [mesh.kib.ki.se]

  A speech pathologist can determine whether the speech deficit is caused by VPI or another speech disorder. A nasoendoscopy is used to view palatal motion during speech and to determine the size and shape of the velopharyngeal gap. [stanfordchildrens.org]

  This can result in several speech disorders, such as: Hypernasal speech Inability to generate pressure for speech sounds Inability to form speech sounds correctly These speech disorders can significantly interfere with your child’s ability to communicate [chop.edu]

• Dysarthria

  Mechanical interference of tonsils, adenoid or posterior pillar web Hypernasal speech after primary or secondary palate repair or adenoidectomy Airway obstruction Ablative palatal lesions Cancer Traumatic injury Congenital motor/neuromotor control (i.e., dysarthria [craniofacialcenter.ucsf.edu]

  Dysarthria (central or peripheral nerve damage) Cerebral palsy, myasthenia gravis, myotonic dystrophy, neurofibromatosis, cerebral or brainstem tumors Cranial nerve damage (IX, X, XII) causing isolated weakness of velum or pharyngeal muscles 4. [ucs.louisiana.edu]

  Other patients are seen with submucous cleft palate, congenital enlarged nasopharynx, post-adenoidectomy, post-tumour excision, dysarthria/dyspraxia. Some patients have associated syndromes such as 22q11 Deletion Syndrome. [gosh.nhs.uk]

  In 1958, Gibbon and Bloomer [6] were the first to advocate the use of a palatal lift appliance (PLA) to treat paralytic dysarthria involving insufficient rhinopharyngeal closure. In the case of a cleft palate, this PLA will not serve any purpose. [j-ips.org]

• Stroke

  Stroke, head trauma, etc. [quizlet.com]

  Acquired VPD may present in persons affected by stroke or head injury, especially if damage occurs to motor centers controlling cranial nerves responsible for pharyngeal muscle control. [emedicine.medscape.com]

  Causes may include stroke, traumatic brain injury, cerebral palsy, or neuromuscular disorders.[3] It is important that the term "velopharyngeal insufficiency" is used if it is an anatomical defect and not a neurological problem.[4] Anatomy[edit] Nasal [en.wikipedia.org]

  • This condition contributes to daytime hypersomnolence and is associated with increased risks for hypertension, cardiovascular disease, and stroke. 65. [slideshare.net]

If there is concern for residual VPI, the subsequent evaluation proceeds in a fashion identical to the pre-operative workup to determine the best available treatment course. Future efforts to standardize. [jclpca.org]

After a thorough review of the patient's history, the standard workup involves perceptual speech evaluation, followed by video nasoendoscopy (VNE) and multiview speech videofluoroscopy (SVF). 7, 8 There is considerable variation in the utilization of [ncbi.nlm.nih.gov]

The treatment of VPD depends on the type and cause of the problem. Velopharyngeal mislearning can only be treated by speech therapy. [craniofacialcenter.ucsf.edu]

Successful treatment was the absence of VPI during playing as visualized by flexible nasopharyngoscopy. [ncbi.nlm.nih.gov]

Perhaps in the future, measures of intraoral air pressure and/ or nasal airflow may be used to facilitate diagnosis of faulty palatopharyngeal valv-ing and prognosis of deviate valving and distorted pressure flow features relative to communication. [cleftpalatejournal.pitt.edu]

Prognosis The combination of surgery to correct the insufficiency and speech therapy to retrain the voice successfully alleviate velopharyngeal insufficiency. Key terms Adenoids — Lymph glands just above the tonsils and the palate. [medical-dictionary.thefreedictionary.com]

Speech prognosis and need of pharyngeal flap for non syndromic vs syndromic Pierre Robin Sequence. J Pediatr Surg. 2008; 43 :668–674. [ PubMed ] 29. Shprintzen RJ. The fallibility of clinical research. [ncbi.nlm.nih.gov]

[…] improve velopharyngeal function and is also important in correcting compensatory articulation habits that develop as a result of longstanding VPI. 1 A multidisciplinary approach when used for the treatment of any deep rooted pathology often gives good prognosis [synapse.koreamed.org]

Its etiology can be anatomical (cleft palate), neurologic, or iatrogenic (after adenoidectomy). The evaluation of a VPI begins with a through speech and language assessment and can be complemented by instrumental investigations. [serval.unil.ch]

Our proposed etiology for the respiratory failure is air tracking from the flap donor site to the pleural spaces of the thoracic cavity via the visceral or prevertebral fascia following positive pressure ventilation. [ncbi.nlm.nih.gov]

An overview of common etiologies follows. Overt cleft palate, either before or after repair, is by far the most common cause of VPD. This condition occurs in approximately 1 of 2000 live births. [emedicine.medscape.com]

Epidemiology Because VPD is multifactorial, the frequency is unknown. For functional causes, determining the frequency is impossible, because some etiologies are acquired and some are congenital. [emedicine.medscape.com]

Differing only in location, the proposed pathophysiologic mechanism of injury is identical to that of the nasogastric tube syndrome, a rare and serious, well described entity consisting of bilateral vocal fold paralysis due to pressure-induced ulceration [ncbi.nlm.nih.gov]

Pathophysiology Oral resonance (as contrasted to nasal resonance) is obtained by means of VPC, which creates a seal between the nasopharynx and the oral cavity. [emedicine.medscape.com]

• This may not be significant pathophysiologically but may be bothersome to the significant other if the snoring prevents the other’s normal and restful sleep. • Upper airway resistance syndrome develops when more significant resistance occurs without [slideshare.net]

Irregular adenoids - Deep indentation or cleft in adenoid tissue prevents tight seal & leads to nasal air emission during speech; May occur after adenoidectomy 6. [ucs.louisiana.edu]

As a result, the patient can be socially and physically rehabilitated with the improved speech quality as well as prevention of leakage of liquids. [ncbi.nlm.nih.gov]

Called also myocardial ischemia. ileocecal insufficiency inability of the ileocecal valve to prevent backflow of contents from the cecum into the ileum. placental insufficiency dysfunction of the placenta, with reduction in the area of exchange of nutrients [medical-dictionary.thefreedictionary.com]