الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The velopharyngeal valve (VPV) comprises the structures that separate the nasopharynx from the oropharynx. The velum elevates and in conjunction with the lateral and posterior pharyngeal walls closes off the nasal cavities from the oral cavity during production of oral sounds which includes vowel sounds and most consonants.
Velopharyngeal closure prevents the flow of air and sound energy into the nasal cavities during these sounds. The most important muscle for providing velopharyngeal closure is the levator veli palatini muscle.
Velopharyngeal dysfunction can occur due to anatomic defects neuromuscular defects and even misleaming of speech. Regardless of the cause, velopharyngeal dysfunction can affect the quality and intelligibility of speech by causing hypemasality, nasal air emission weak or omitted consonants, short utterance length and compensatory speech errors.
The evaluation of VPD consists of a thorough patient history clinical examination, perceptual speech assessment and instrumental anatomical assessment of velopharyngeal closure.
The evaluation of VPD requires the interaction of an interdisciplinary team. The phoniatrician is an integral part of the VPD team, particularly because perceptual speech assessment remains the gold standard of diagnosis of VPD and speech therapy is an important adjunct in treating compensatory speech behaviors Treatment options for velopharyngeal insufficiency consist of prosthetic management or surgery, supplemented with speech therapy.