Structural aetiology
Velopharyngeal insufficiency results from any structural deficiency of the velum or pharyngeal wall at the level of the nasopharynx. There is either a deficiency of tissue or a structure mechanically interferes with closure. Causes include:
- unrepaired palatal clefts:
- overt
- submucous
- occult submucous
- mechanical interference:
- excessive tonsils
- posterior pilar webbing
- post-surgical insufficiency:
- after palatal closure, pharyngoplasty, adenoidectomy
- post-operative fistula
- ablative palatal lesions:
- cancer
- trauma
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