Velopharyngeal Insufficiency

Velopharyngeal insufficiency (VPI) occurs when air and sound escape from the child’s nose during speech, producing speech that sounds nasal in quality. VPI may lead to hoarseness or fatigue of your child’s voice.

What causes velopharyngeal insufficiency?

Normal speech is produced when the soft palate closes off the nasal cavity, allowing the air to escape through the mouth. Velopharyngeal insufficiency is caused when the soft palate cannot block off the nasal cavity, letting the air go out through the nose.

How is velopharyngeal insufficiency treated?

The first step in diagnosing and treating velopharyngeal insufficiency is making sure that your child has normal hearing and no signs of an ear infection. The next step is taking your child to a speech therapist who can listen to your child’s voice. Sometimes, speech therapy alone can improve your child’s speech disorder. In cases of severe speech disorders, surgery may be required.


The timing and type of surgery depends on your child’s condition and on the plastic surgeon. Further speech therapy may be required after surgery.

What else should I know about this procedure?

As a cleft and craniofacial specialist, Dr. Aboutanos is qualified and ready to care for your child as your child grows and develops. She is a member of the accredited Cleft and Craniofacial Team at St. Mary’s Hospital, and she will help coordinate your child's care with other specialists in a multi-disciplinary manner.