3.4 Causes of Velopharyngeal Dysfunction Flashcards Preview

ECU Craniofacial Anomalies + Laryngeal Rehab > 3.4 Causes of Velopharyngeal Dysfunction > Flashcards

Flashcards in 3.4 Causes of Velopharyngeal Dysfunction Deck (23):
1

What are the organic causes of hypernasality/NAE?

(5)

- Congenital Palatal Insufficiency (Deep pharynx)
- Neuromuscular Disorders
- Cleft palate
- Ablative surgery
- Radiation to Nasopharynx

2

What are the non-organic causes of hypernasality/NAE?

- functional/ sound specific

3

What are the causes of hyponasality?

(2)

- Nasal Obstruction
- Pharyngeal Obstruction

4

What are the signs of a submucous cleft?

(5)

- Absent or broad posterior nasal spine
- No color change
- Anterior attachment of the levators
- Zona Pellucida
- Bifid Uvula

5

A high arched palate will not typically cause what?

A VPI

6

What are the signs of congenital palatal Insufficiency: deep Nasopharynx?

(4)

- Hypernasality is the primary presenting factor
- Palate appears normal
- Nasal regurgitation as newborn may be first sign
- Occurs rarely following maxillary advancement

7

What occurs after an adenoidectomy when you have a congenital palatal insufficiency?

Deep nasopharynx is unmasked (velopharyngeal mechanism seems able to adjust to slow involution but not the sudden increase with adenoidectomy

8

What are the signs of a lower motor lesion?

(4)

- Flaccidity
- Atrophy
- Fasciculations
- Usually unilateral, but may be bilateral

9

What are the signs of an upper motor lesion?

Both larynx and velum should be assessed (one may be paralyzed)

10

When can neuromuscular insufficiency occur?

(3)

- Congenitally (Moebius or velocardiofacial syndrome)
- Tumors (congenital or acquired)
- Surgically or via a trauma

11

How is the velum for functional/sound specific VPI?

Velum is neurologically and anatomically capable of closure at time of evaluation

12

What is the most likely cause of functional/sound specific VPI?

Most likely cause is early Conductive Hearing Loss

13

In regards to functional/sound specific VPI, what happens after post T&A with tubes?

improved hearing increases speech output and unmasks the "posterior nasal fricative"

14

Functional/sound specific will not respond to what?

Surgery or Prosthetic management

15

What does functional/sound specific require?

Speech therapy

16

Functional/sound specific is truly a misarticulation using what?

posterior nasal fricative

17

What is apraxia of speech?

Motor speech disorder causing difficulty combining and sequencing motor movements

18

What subsystems of speech does apraxia of speech affect?

(3)

- Phonation
- Articulation
- Velopharyngeal function

19

Apraxia of speech has poor ______________, ____________, and _____________ of VP closure.

coordination, timing, and duration

20

Apraxia of speech causes what?

inconsistent hypernasality/ hyponasality

21

What happens during apraxia of speech?

velum elevates inappropriately for nasal sounds and remains open for oral sounds

22

What are the nasal airway obstruction?

(10)

- Nasal cleft deformities
- Allergic Rhinitis
- Vasomotor rhinitis
- Bacterial URL
- Choanal atresia
- Nasal cavity mass
- Septal deviation
- Turbinate enlargement
- Nasal hygiene
- Maxillary retrusion (seen in down, apert, crouzon syndromes)

23

What are the pharyngeal airway obstruction?

(6)

- Hypertrophied tonsils
- Hypertrophied adenoids
- Complications of cleft palate/craniofacial and airway surgery
- Pharyngoplasty: pharyngeal flap/sphincter
- Stenosis following T+A
- Mandibular Retrusion (Pierre Robin Sequence)