The Velopharyngeal Dysfunction Program (or VPD Program) at Bellevue Ear Nose and Throat offers coordinated treatment and continuous care for patients diagnosed with VPD from early childhood into adulthood. Velopharyngeal dysfunction includes the diagnosis of velopharyngeal insufficiency (VPI), submucous cleft palate and other related disorders.

The VPD Program provides a comprehensive clinical evaluation in a single visit, starting with an assessment by a speech pathologist, a pediatric otolaryngologist, a facial plastics surgeon and an audiologist if needed.

Children with velopharyngeal dysfunction benefit from coordinated care that brings together all of the specialties that may be needed to manage both the anatomic and functional aspects of the condition.

What we treat

VPD causes difficulty with speech and/or swallowing due to abnormal function of the velopharynx which encompasses the soft palate as well as the side and back walls of the throat. These structures comprise a “valve” that separates the oral and nasal cavities during swallowing and speech. If there is velopharyngeal insufficiency, closure does not occur properly, and liquids, food or excess air can escape through the nose. This primarily manifests in difficulty with certain speech sounds, particular the sounds which require closure of the velopharynx such as “s”, “sh”,  and “z”.  Depending on the severity, VPD can hamper articulation and communication and be a source of frustration for children, parents and adults with this issue.

VPD can result from anatomic, neurologic or other functional causes, and can occur by itself or in association with other medical conditions. We treat patients with all forms of VPD.

Appointments and evaluations

Patients may be referred to the VPD Program by a variety of specialists. We frequently see children who are directed to our program by a speech pathologist, pediatrician, other ENT specialists, geneticist or other clinicians.