Velopharyngeal Dysfunction Program

Founded in 2011, the Velopharyngeal Dysfunction Program (or VPD Program) at The Children’s Hospital of Philadelphia offers coordinated treatment and ongoing care for patients diagnosed with velopharyngeal dysfunction (VPD). Velopharyngeal (veal-o-phar-in-geal) dysfunction includes the diagnosis of velopharyngeal insufficiency (VPI), submucous cleft palate and other related disorders.

Co-directed by the Division of Plastic, Reconstructive and Oral Surgery and the Department of Speech-Language Pathology, the VPD Program provides a comprehensive clinical evaluation in a single visit, starting with an assessment by a speech pathologist and a plastic surgeon.

Children with velopharyngeal dysfunction benefit from coordinated care that brings together all of the related specialties that may be needed to manage both the physical and functional aspects of the condition. This might include plastic surgery, speech pathology, audiology, psychology, genetics or radiology. The VPD Program works closely with the Cleft Lip and Palate Program, the Division of Otolaryngology (also known as Ear, Nose and Throat, or ENT), Genetics, and the Sleep Center in the Division of Pulmonology to manage your child’s care.

In addition to providing the best possible care for your child, we are committed to ongoing research that will improve outcomes and treatment options for children with VPD in the future. We collaborate with the Division of Human Genetics and the 22q and You Center – the largest such center in the world – in ongoing efforts to improve standards of care for the management of VPD in patients with the 22q11.2 deletion syndrome.

What we treat

VPD causes complications with speech and swallowing due to abnormal function of the velopharyngeal valve, which includes the soft palate as well as the side and back walls of the throat. The purpose of these structures is to separate the oral and nasal cavities during swallowing and speech.

When velopharyngeal closure does not occur properly, food or excess air can escape through the nose. This can result in hypernasal speech, the inability to generate pressure for speech sounds, and the inability to form speech sounds correctly. These speech disorders can significantly interfere with your child’s ability to communicate effectively.

VPD can result from structural, neuromotor or other functional causes, and can occur in isolation or in conjunction with other medical or genetic conditions. The VPD Program treats patients with all forms of VPD.

Conditions treated in this clinic include VPD resulting from the following:

• Cleft palate
• Submucous cleft palate
• Hypernasality following adenoidectomy
• Congenital VPD not associated with any of the above
• Disorders associated with genetic syndromes
  • Neurofibromatosis (NF)
  • Kabuki syndrome
  • 22q11.2 deletion syndrome. We are part of CHOP’s internationally recognized 22q and You Center, which specializes in the diagnosis and multidisciplinary management of children with a chromosome 22q11.2 deletion.
• Palatal tumors

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, ENT specialist, geneticist or other clinicians.

Learn more about what to expect during your child's evaluation.

Updated January 2014