Ear, Nose, & Throat (Otolaryngology)

Voice & Velopharyngeal Disorders

Skilled care for voice and velopharyngeal disorders

NewYork-Presbyterian's two children's hospitals both provide comprehensive programs for children with voice problems ranging from hoarseness to hypernasality (also known as velopharyngeal insufficiency). In children with hypernasality, the palate and pharynx (throat) tissues do not close properly, causing air to escape through the nose during speech. The problem originates in the velopharynx, the division between the back of the mouth and the back of the nose — two areas that are normally separated by the soft palate, which helps to seal off that region.

If your child lacks the ability to close that separation, he or she may have hypernasality, possible causing a speech disorder that ranges from very subtle to severe enough that only you can understand what he or she is saying. Severe hypernasal speech can affect your child socially, which can seriously affect self-esteem and emotional development and growth. NewYork-Presbyterian's pediatric hypernasality experts offer:

Skilled, advanced diagnosis

• Experts in our programs strive to provide an accurate diagnosis and effective treatments to improve your child's speech and enhance his or her quality of life.
• We work with speech therapists to provide your child with a thorough assessment and diagnosis using a comprehensive approach called "perceptual speech analysis."
• We assess your child with a "video-nasopharyngoscopy," in which we insert a flexible fiberoptic telescope into the nose to see the anatomy of the nasopharynx.
• We use a full range of diagnostic tests, including videofluoroscopy of the neck, to evaluate the way your child's velopharyngeal valve closes.

Effective, expert treatment

Nonsurgical treatments

For many children, we can correct hypernasality with speech therapy. We work closely with a dedicated, skilled team of speech pathologists with expertise in velopharyngeal insufficiency. We may recommend a special device to lift your child's palate or to help seal off the back of the throat.

Surgery

If your child's velopharyngeal insufficiency is best corrected with surgery, our surgeons have years of clinical experience performing even the most complicated surgeries to correct hypernasality, including techniques such as:

• Furlow palatoplasty
• Sphincter pharyngoplasty
• Intervelar veloplasty
• Pharyngeal flap

Contact