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Velopharyngeal insufficiency (VPI) is known as a failure of the separation between nose and mouth, because of an anatomical dysfunction of the soft palate, the lateral or posterior wall of the pharynx. The effect of such a dysfunction leads to functional problems with speech(hypernasality), eating and breathing.〔Hirschberg J. Results and Complications of 1104 Surgeries for Velopharyngeal Insufficiency. ISRN Otolaryngol. 2012.181202〕 This gap can be treated surgically, although the operational technique which should be used is still controversial. The main object is to visualize the preoperative velopharyngeal dimensions and movements and adjust your postoperative goal upon these results. There are different diagnostic tools which can help visualize these movements and dimensions. This tools will be reviewed in this article. The terms velopharyngeal "incompetence", "inadequacy" and "insufficiency" historically have been used interchangeably, although they do not necessarily mean the same thing. Velopharyngeal insufficiency includes any structural defect of the velum or pharyngeal walls at the level of the nasopharynx with insufficient tissue to accomplish closure, or there is some kind of mechanical interference with closure.〔Peter D. Witt, D’Antonio. Velopharyngeal insufficiency and secondary palatal management. Clinics in plastic surgery. 1993. Oct;20(4):707-21.〕 It is important that the term insufficiency is used if it is an anatomical defect and not a neurological problem. Velopharyngeal insufficiency (VPI) can be caused by a variety of disorders (structural, genetic, functional or acquired) and is very often associated with a cleft palate. Abnormal physiological separation of the oropharynx from the nasopharynx can lead to VPI and hypernasality.〔Wermker K, Lünenbürger H, Joos U, Kleinheinz J, Jung S et al. Results of speech improvement following simultaneous push-back together with velopharyngeal flap surgery in cleft palate patients. J Craniomaxillofac Surg. 2013 Sep 13. pii: S1010-5182(13)00219-9.〕 The main objective of this article is to create an overview of the differential methods and (non-)surgical treatment of VPI. ==Anatomy== image:pharyngeal_flap_procedures1.svg|1. Nasal cavity 2. Hard palate 3. Soft palate 4. Tongue 5. Lips 6. Tissue used for surgery. image:Illu pharynx.jpg 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Velopharyngeal insufficiency」の詳細全文を読む スポンサード リンク
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