All about VPI (Velopharyngeal Insufficiency)

Seattle Children's

10 Nov 202103:15

Summary

TLDRIn this video, Katie, who recently moved from California, struggles with velopharyngeal insufficiency (VPI), a speech disorder that makes her hard to understand. She visits a clinic where a speech pathologist and doctor assess her condition using a camera and x-ray to observe her speech muscles. They explain VPI, where the soft palate doesn't seal off the nasal passage during speech, causing air to escape through the nose. The treatment options discussed are an obturator or surgery, with Katie recommended for sphincter pharyngoplasty. The video highlights the collaborative effort to improve Katie's speech clarity.

Takeaways

😀 Katie has recently moved from California and is experiencing difficulty being understood due to her speech condition.
🗣️ Katie's condition is called Velopharyngeal Insufficiency (VPI), which affects her speech clarity.
👨‍⚕️ Peter and Katie visit a clinic to consult with a speech pathologist and a doctor to address Katie's speech challenges.
🔍 The speech pathologist assesses Katie's speech by asking her to say specific words and uses a camera to examine her speech muscles.
👩‍⚕️ The doctor explains the process of using a camera and X-ray to further investigate the cause of Katie's speech difficulties.
🔎 VPI is diagnosed when the soft palate cannot touch the back of the throat, allowing air to escape through the nose during speech.
🛠️ Treatment options for VPI include the use of an obturator or surgical procedures to correct the issue.
🏥 Two main surgical options are presented: sphincter pharyngoplasty, which creates a speed bump for the palate, and a furlopalitoplasty, which repositions the muscles.
👩‍🏫 The medical team recommends sphincter pharyngoplasty for Katie after evaluating her condition with the help of a scope and video X-rays.
🤝 Katie and her team will collaborate to develop a plan to improve her speech clarity and address the challenges caused by VPI.

Q & A

What is velopharyngeal insufficiency (VPI)?
-Velopharyngeal insufficiency (VPI) is a condition where the soft palate cannot touch the back of the throat to separate the nose from the mouth during speech, allowing air to escape through the nose, which makes speech harder to understand.
Why is Katie having difficulty with her speech?
-Katie has velopharyngeal insufficiency, which affects her speech by allowing air to escape through her nose instead of her mouth, making her speech hard to understand.
What is the purpose of the speech pathologist's evaluation?
-The speech pathologist evaluates Katie's speech to assess how her speech muscles move and to determine the extent of her VPI, which will help in planning her treatment.
What does the doctor plan to do with the camera in Katie's nose?
-The doctor will use a camera in Katie's nose to visually examine her speech muscles in action and to understand why air is escaping through her nose during speech.
What is the significance of saying 'pull the baby buggy' during the evaluation?
-Saying 'pull the baby buggy' is a specific phrase used to test speech sounds that require the palate to close off the nasal passage, helping to diagnose VPI.
What are the treatment options for VPI mentioned in the script?
-The treatment options for VPI mentioned are using an obturator or undergoing surgery, with two main types of surgery being sphincter pharyngoplasty and furlopalitoplasty.
What is an obturator and how is it used in treating VPI?
-An obturator is a device that is placed in the mouth to help close off the nasal passage during speech, forcing all the air to come out of the mouth and improving speech clarity.
What is sphincter pharyngoplasty and why is it recommended for Katie?
-Sphincter pharyngoplasty is a surgery where a speech bump is created at the level where the palate is trying to touch the back of the throat. It is recommended for Katie because the muscles of her palate are in the normal position and the surgery aims to improve the palate's movement.
What is furlopalatoplasty and when is it recommended?
-Furlopalatoplasty is a surgical procedure recommended when the muscles of the palate are not in the correct position or are moving in the wrong direction, aiming to reposition the muscles to a normal orientation.
How does the x-ray video with nasal drops contribute to Katie's diagnosis?
-The x-ray video with nasal drops helps visualize the movement of Katie's soft palate and the separation of her nasal and oral cavities during speech, providing further insight into her VPI.
What is the ultimate goal of the treatment plan for Katie?
-The ultimate goal of the treatment plan is to improve Katie's speech clarity by addressing the air escape through her nose and ensuring that it comes out of her mouth during speech.

Outlines

00:00

🗣️ Introduction to Velopharyngeal Insufficiency

The script introduces Katie, who has recently moved from California and suffers from velopharyngeal insufficiency (VPI), a condition that makes her speech hard to understand. Peter, who has clear speech, converses with Katie, and they discuss her difficulties at school due to her speech impediment. Katie's family is visiting a clinic to consult with a speech pathologist and a doctor to understand her condition better and explore treatment options.

Mindmap

Keywords

💡Velopharyngeal Insufficiency (VPI)

Velopharyngeal Insufficiency (VPI) is a condition where the soft palate does not make proper contact with the back of the throat during speech, leading to nasal escape of air and difficulty in speech production. In the video, Katie suffers from VPI, which makes her speech hard to understand. The script discusses the impact of VPI on Katie's life and her journey to seek medical help to improve her speech.

💡Speech Pathologist

A speech pathologist is a professional who specializes in the evaluation, diagnosis, and treatment of speech, language, voice, and fluency disorders. In the script, the speech pathologist plays a crucial role in assessing Katie's speech and recommending appropriate therapies or interventions. They ask Katie to say specific words to evaluate her speech patterns.

💡Obturator

An obturator is a dental appliance used to manage velopharyngeal insufficiency. It is placed in the mouth to help close the gap between the soft palate and the back of the throat, redirecting airflow through the mouth and improving speech clarity. The script mentions the obturator as one of the treatment options for VPI, highlighting its role in managing the condition.

💡Sphincter Pharyngoplasty

Sphincter pharyngoplasty is a surgical procedure used to treat velopharyngeal insufficiency. It involves creating a 'sphincter' or a muscular ring at the junction of the soft palate and the posterior pharyngeal wall to improve contact during speech. The script discusses this surgery as the recommended treatment for Katie, emphasizing its potential to improve her speech by enhancing the closure of her velopharyngeal mechanism.

💡Furlow Palatoplasty

Furlow palatoplasty is a specific type of surgery for cleft palate repair, which can also be used to treat velopharyngeal insufficiency. It involves repositioning the muscles of the soft palate to improve their function. In the script, this surgery is mentioned as an alternative treatment option if the muscles of the palate are not in the normal position or are not moving effectively.

💡Anesthesia

Anesthesia is a medical state that provides pain relief during surgical procedures. In the context of the script, anesthesia is used during the surgical treatments for VPI, ensuring that the patient, Katie, does not experience pain while the surgery is performed.

💡X-ray

An X-ray is a diagnostic imaging technique that uses ionizing radiation to visualize internal structures of the body. In the video, X-rays are used to assess Katie's velopharyngeal function while she speaks, helping the medical team understand the cause of the air escaping through her nose and not her mouth.

💡Soft Palate

The soft palate is the rear, movable part of the roof of the mouth that plays a critical role in speech, swallowing, and preventing nasal regurgitation of food. In the script, the soft palate's inability to touch the back of the throat is central to Katie's VPI diagnosis and the subsequent discussions about treatment.

💡Nasal Regurgitation

Nasal regurgitation refers to the involuntary passage of fluids or food through the nose, which can occur due to velopharyngeal insufficiency. The script implies this issue when discussing the impact of VPI on speech and the need for treatment to redirect airflow through the mouth.

💡Airflow

Airflow in the context of speech production refers to the controlled movement of air through the vocal tract to produce speech sounds. The script emphasizes the importance of proper airflow for clear speech, as Katie's VPI condition affects her ability to direct air solely through her mouth.

Highlights

Introduction of Katie, who recently moved from California and has velopharyngeal insufficiency (VPI).

Katie's speech is difficult to understand due to her VPI condition.

Peter's inquiry about Katie's school experience and the challenges she faces with her speech.

Katie and her family visit the clinic to consult with a speech pathologist and a doctor.

The speech pathologist asks Katie to say specific words to assess her speech.

A camera is used to observe Katie's speech muscles movement during speech tasks.

The doctor explains the process of using a camera to examine Katie's nose and throat while she speaks.

X-ray video is taken to further analyze the air flow during Katie's speech.

Explanation of VPI, its cause, and how it affects speech clarity.

Introduction of treatment options for VPI, including an obturator or surgery.

Description of two main surgical procedures for VPI: sphincter pharyngoplasty and furlopalitoplasty.

Recommendation for Katie to undergo sphincter pharyngoplasty based on her specific condition.

The importance of understanding air flow during speech to improve Katie's speech clarity.

Collaborative approach between Katie, her family, and medical team to develop a treatment plan.