Stress velopharyngeal incompetence: Two case reports and options for diagnosis and management

Nikhila Raol; Gillian Diercks; Cheryl Hersh; Christopher J Hartnick

doi:10.1016/j.ijporl.2015.10.013

Stress velopharyngeal incompetence: Two case reports and options for diagnosis and management

Int J Pediatr Otorhinolaryngol. 2015 Dec;79(12):2456-9. doi: 10.1016/j.ijporl.2015.10.013. Epub 2015 Oct 21.

Authors

Nikhila Raol¹, Gillian Diercks¹, Cheryl Hersh², Christopher J Hartnick³

Affiliations

¹ Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA.
² Department of Speech Language Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
³ Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA. Electronic address: Christopher_hartnick@meei.harvard.edu.

PMID: 26531005
DOI: 10.1016/j.ijporl.2015.10.013

Abstract

Stress velopharyngeal incompetence (SVPI) commonly affects brass and wind musicians. We present a series of two patients who presented with nasal air emission following prolonged woodwind instrument practice. Neither patient demonstrated audible nasal air emission during speech, but endoscopy revealed localized air escape/bubbling from different sites for each patient with instrument playing only. Both underwent tailored surgical treatment with resolution of symptoms during performance. Diagnosis of SVPI requires examination during the action that induces VPI to allow for directed management. Treatment should be targeted based on nasopharyngoscopy findings.

Keywords: Speech disorder; Stress VPI; VPI; Velopharyngeal incompetence.

Publication types

Case Reports

MeSH terms

Adolescent
Endoscopy*
Female
Humans
Male
Music*
Stress, Physiological
Velopharyngeal Insufficiency / diagnosis*
Velopharyngeal Insufficiency / surgery*