What is “velopharyngeal incompetence” (VPI)?
• Velopharyngeal incompetence or VPI is the inability of the velum (soft palate) and related musculature to close the nasopharynx, separating the oral and nasal cavities for the production of oral consonants. A VPI can be caused by a deficiency of the velum or an increased size of the pharynx. The latter is difficult to diagnose without imaging. • A VPI usually has a physiological origin and requires physical management such as surgery or prosthesis. • A VPI may have a “functional” origin from misuse of the velum. Some unique misarticulations such as the “nasal snort” (now more correctly labeled a “posterior nasal fricative”) involve a “functional misuse of the velum” and will only resolve with appropriate speech therapy. • A VPI might also be considered when the nasopharynx is obstructed and cannot open adequately for breathing and producing the three nasal consonants (resulting in hyponasality). The cause may be hypertrophied adenoids, aggressive pharyngoplasty or narrowed nasopharyn
