Surgery for Velopharyngeal Dysfunction.

The velopharynx is comprised of complex musculature that works together to achieve closure of the velopharyngeal port during deglutition and speech. Failure of this mechanism results in velopharyngeal dysfunction, manifesting as nasal regurgitation and hypernasal speech. A thorough evaluation with a multidisciplinary team of otolaryngology and/or a surgeon trained in cleft/craniofacial surgery and speech languagy pathology can identify the underlying cause and relevant anatomy, which should be incorporated into decisions regarding surgical techniques. The most common surgical approaches for VPI are pharyngeal flap, sphincter pharyngoplasty, and Furlow palatoplasty, but many alternative techniques can be utilized depending on patient factors and new surgical concepts.