After a general ENT examination to rule out issues like hearing loss and problems with the mouth, tongue and voice, a detailed assessment is conducted. This involves passing a small flexible scope through the nose to observe the soft palate's movement during speech. Conducted alongside a speech therapist, this assessment determines the presence of a velopharyngeal gap and identifies any weaknesses or insufficiencies., and accurately identify the level, side and site of any weakness or insufficiency of the soft palate.
Voice Assessment
This comprehensive evaluation includes a voice history, visual imaging (e.g. laryngeal mirror, nasendoscopy, videostroboscopy), perceptual judgements of voice quality, acoustic measures such as pitch and intensity, and aerodynamic measures e.g., airflow rate and postural evaluations. The ENT surgeon / laryngologist collaborates with the speech therapist to gather and interpret all this data for a diagnosis.
Videostroboscopy
Specialised clinics offer videostroboscopic voice assessments, providing a slow-motion view of the vocal folds to uncover abnormalities that may not be visible in standard examinations. This technique is particularly effective in identifying subtle issues like mild vocal cord swelling.
Voice Therapy
Voice therapy includes advice and exercises for correcting poor vocal habits, misuse, and techniques for voice projection and modulation.
VPI treatment
Many patients with VPI benefit from speech therapy alone, without requiring surgery. For some, surgical intervention may be necessary. Post-surgery, the patient typically stays one night in hospital and can resume eating and drinking. Continued speech therapy post-surgery is crucial to optimise speech outcomes.