GOOD speech depends upon intact velopharyngeal closure. The muscles of the soft palate and pharynx, and especially the levator palati, palatopharyngeus and superior constrictor, act as a sphincter which has the ability to separate the oropharynx from the nasopharynx.1 This separation averts leak of air through the nose which is the cause of hypernasality (rhinolalia). There is greater contraction of these muscles for high vowels (i) (u) than for the low vowels (e) (a), and even the contraction for the low vowels is greater than for the nasal consonants.2 Thus greater force of muscle contraction may be required to produce speech that is nonnasal in quality.
Among the causes of velopharyngeal incompetence are cleft palate, cranial base anomalies, paralysis of the soft palate, and alteration of the size of the palatopharyngeal orifice by tonsillectomy and adenoidectomy. The most frequent cause is cleft palate.
Secondary surgery is the main
Chaco J, Yules RB. An Electromyographic Study of Pharyngeal Flap Operation. Arch Otolaryngol. 1969;90(1):83–84. doi:10.1001/archotol.1969.00770030085016
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