Demystifying Velopharyngeal Dysfunction for Plastic Surgery Trainees-Part 1: Anatomy and Physiology.

Area of Science:

• Anatomy and Physiology
• Speech Pathology
• Surgical Sciences

Background:

• The velopharyngeal (VP) port is crucial for separating the nasopharynx and oropharynx.
• Velopharyngeal dysfunction (VPD) impairs VP port closure, affecting speech and swallowing.
• VPD is often linked to cleft palate but has diverse causes, including structural, neuromuscular, and behavioral factors.

Purpose of the Study:

• To provide a comprehensive, 3-part discussion on the velopharyngeal mechanism and velopharyngeal dysfunction (VPD).
• To offer foundational knowledge for surgical trainees on VPD diagnosis and management.
• To clarify terminology and assessment principles for velopharyngeal function.

Main Methods:

• Part 1 focuses on the anatomy and physiology of the velopharyngeal port and causes of VPD.
• Discussion includes velopharyngeal insufficiency, incompetence, and mislearning.
• Highlights the need for a multidisciplinary approach involving surgeons and speech-language pathologists.

Main Results:

• VPD classification includes structural deficits (insufficiency), neuromuscular issues (incompetence), and maladaptive habits (mislearning).
• Non-cleft causes of VPD are varied, encompassing congenital/acquired defects, neuromuscular conditions, and developmental factors.
• Effective diagnosis and management necessitate collaboration between surgical and speech pathology teams.

Conclusions:

• A thorough understanding of VPD requires knowledge of its spectrum, speech pathology principles, and terminology.
• This series aims to be an accessible resource for surgical trainees new to VPD.
• Integrated knowledge is essential for optimal surgical decision-making and patient outcomes.