What are methods for physical management of VPI?
Prosthetic and surgical methods are common. Each procedure has been developed to manage a different type of VPI. When is physical management of velopharyngeal incompetence necessary? • Speech is unintelligible due to VPI. • Articulation is imprecise due to loss of oral pressure. • Misarticulations such as glottal stops cannot be corrected because of nasal air pressure loss. • Speech is distorted from hypernasal distortions. What are the prosthetic management procedures? The common prosthetic procedures are the “palatal lift” and the “palatal obturator.” • A palatal lift is appropriate when the VPI is caused by poor movement of the velum. The anterior, retaining portion clasps to the teeth and a posterior tailpiece pushes the soft palate up into position to obturate the nasopharynx. • A palatal obturator is appropriate when the VPI is caused by a deficiency in the length of the soft palate to close the velopharyngeal port. That is, the velum may move, but may not be long enough, or the
