Miniseminar: Velopharyngeal dysfunction: An interdisciplinary approach

Abstract

Velopharyngeal dysfunction is a common pathophysiological condition that can significantly affect speech production and speech intelligibility. A wide variety of anatomic and physiologic processes, including iatrogenic interventions, can adversely impact the velopharyngeal mechanism and affect the ability of individuals to effectively communicate with others. While a number of these abnormalities are congenital and developmental in origin, many sources of dysfunction can occur later in life as a result of surgery, nasal obstruction, maxillofacial trauma, and other processes. The purpose of this symposium is to concentrate on those acquired sources of velopharyngeal dysfunction that present a significant impact to patients whose speech quality and intelligibility are compromized. It will not review the various congenital or craniofacial developmental anomalies that primarily affect the pediatric population. Since velopharyngeal dysfunction affects a variety of anatomic regions and structures of the head and neck, its diagnosis and treatment cross traditional professional lines. Successful management of these patients requires the interactive contributions of a number of specialists with various areas of expertise in maximizing the rehabilitation and treatment of these patients. For that reason, the current symposium will use a multidisciplinary discussion of the problem of velopharyngeal dysfunction. The faculty of this program therefore consists of a speech pathologist, a maxillofacial prosthedontist, a head and neck oncologic surgeon, and a rhinologist, each of whom will provide a complementary discussion of this important problem. The current program will first present a discussion of the normal anatomy and physiology of the velopharyngeal mechanism. It will describe the important anatomic structures involved in speech production at this level and will review their relevant functional characteristics. It will next discuss nasal and nasopharyngeal processes that impact velopharyngeal function. Once a full discussion of normal function and structure is completed, a close examination of pathophysiology will follow. A major portion of the discussion will focus on acquired defects of the velopharyngeal mechanism, often created incident to major resections of head and neck neoplasms. Approaches to reconstruction of these defects, as well as to the use of appropriate prostedontic devices, will then be discussed. The purpose of this symposium is to present the importance of an interactive, cooperative head and neck team to the rehabilitation of patients with velopharyngeal dysfunction. Through this comprehensive interdisciplinary approach, patients who have a significant impact of velopharyngeal dysfunction on speech quality and intelligibility can be managed in the most appropriate manner, increasing the likelihood for a successful outcome, and improving their treatment and rehabilitation.