Velopharyngeal insufficiency is due to the pathological changes of soft palate or pharyngeal wall or the coordinated movement of soft palate and pharyngeal muscle, which makes the velopharyngeal unable to close normally, leaving gaps of different sizes and shapes, leading to poor communication between oral cavity and nasopharyngeal cavity during pronunciation, resulting in pronunciation and swallowing disorders. Congenital cleft palate is more common after operation, and 5% ~ 44% patients leave velopharyngeal insufficiency after cleft palate repair.

Etiology: Congenital causes include soft palate paralysis, central or peripheral nervous system injury; Acquired causes include velopharyngeal insufficiency after cleft palate surgery, resection of velopharyngeal tumor, paralysis of soft palate caused by radiotherapy in palatopharyngeal region, communication between oral cavity and nasal cavity caused by palatal fistula, and soft palate defect caused by trauma.

Typical symptoms: the velopharyngeal cavity cannot be closed during pronunciation, resulting in nasal opening, unclear pronunciation and language disorder. Food can flow back to the nasal cavity when swallowing, especially when eating liquid food. Because the eustachian tube cannot be opened normally, there may be ear tightness, obstruction and hearing loss.