Velopharyngeal insufficiency (VPI)

Velopharyngeal insufficiency (VPI) is a failure of the body's ability to temporarily close the communication between the nasal cavity and the mouth, because of an anatomic dysfunction of the soft palate or of the lateral or posterior wall of the pharynx. To treat it various surgical procedures are available but one of the best option is furlows double opposing Z palatoplasty.

In Richardsons dental and craniofacial hospital, a patient with a history of previously operated  cleft lip and palate came with a chief complaint of improper speech. The speech assessment was done by the team of doctors headed by Dr Sunil Richardson and the speech pathologist. On evaluation the speech abnormalities were detected.

In cleft palate patients usually the velopharyngeal incompetency is due to the altered arrangement of palatal muscles and this procedure called  double opposing z plasty re-orients the muscles of the palate into their normal transverse position and also lengthens the soft palate which helps in attaining the seal between the soft palate and the throat that is essential for producing certain sounds. Post surgery, speech therapy is mandatory for the patient to achieve best results.

The same furlows palatoplasty was done for our patient and patient was painfree in the post op period. He was advised to take liquid diet for few days after which he was transferred to his normal diet. There was no sign of dehiscence, the wound healed well and patient is now on regular follow up. Patient is undergoing speech therapy once in a week and now there is a tremendous improvement in speech in just 6 months of period. The patients parents are very satisfied with the speech of the patient.


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