Causes of Velopharyngeal Incompetence

VPI is a structural or functional aberration of the velum, pharynx, or both that underlies an accompanying speech problem. The onset of VPI may occur anytime during an individual's life but is most prevalent in children between the ages of about 2 through 5 and is typically a sequela of cleft palate. The cleft is usually overt and repaired surgically during infancy but may be a submucous cleft palate in which surgical repair generally occurs later in life. VPI sometimes also accompanies a pharyngeal deficit, particularly a deep pharynx. Other important causes of VPI include various neurologic disorders and hearing loss, although the latter may be qualitatively different from the VPI attributable to other sources. This report is a discussion of these etiologies.