Patients present with an overall nasal tone to their voice (hypernasality) and/or air coming down their nose (nasal emission, nasal turbulence), sometimes together with consonant articulation problems.
Approximately 50 per cent of patients seen within this service have had a cleft palate repair.
Other patients are seen with submucous cleft palate, congenital enlarged nasopharynx, post-adenoidectomy, post-tumour excision, dysarthria/dyspraxia. Some patients have associated syndromes such as 22q11 Deletion Syndrome.
Patients are seen for special tests which include a moving X-ray (lateral videofluoroscopy), sometimes the use of a tiny telescope to look at the back of the throat during speaking (nasendoscopy), as well as detailed speech assessment and measurements of the voice using a computer.
Management usually includes surgery, but prosthetics, including the use of a speech bulb obturator and palatal lift, are used in a small group of patients. Speech therapy is also a treatment option.
Velopharyngeal dysfunction clinic
22q11 deletion syndrome clinic