Insuffisance vélopharyngée

Velopharyngeal incompetence is a disease that occurs most of the time in children. Its therapeutic management involves several specialists (an ENT surgeon, a maxillofacial surgeon, and a speech therapist). The complexity of the disease is related to both the anatomy and the physiology of the velopharyngeal sphincter, as well as to the multiplicity of potential aetiologies (functional, neurological, surgical, etc.). Investigations for such incompetence must include Magnetic Resonance Imaging (MRI), flexible fiberoptic endoscopy and aerodynamic tests. The treatment is firstly based on phoniatric evaluation, then on a speech therapy that must be undertaken as early as possible, and that must precede and follow any surgical treatment. Surgery of velopharyngeal incompetence has no gold standard. There are many techniques available, among which the most famous are the velopharyngoplasties and active or passive pharyngoplasties.