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VPI or velopharygeal incompetency consists of air escape through the nose and therefore normal speech sounds cannot be made. VPI is first treated by a speech therapist at the time of speech development. If VPI is still present after the speech therapy, a surgical procedure may be warranted. A screening test (nasoendoscopy) may be needed and Dr. Gargano will tailor your procedure based on the test results.

VPI Surgery Objectives

  • To close the space at the back of throat and avoid air escape through the nose 
  • To gain a normal speech development.
  • To avoid breathing problems such as obstructive sleep apnea.

State of the Art Techniques

Dr. Gargano evaluates VPI with a speech therapist and then will perform a nasoendoscopy. Depending on the anatomical defect will perform either a pharygeoplasty (sphincter tightening) procedure or pharyngeal flap procedure. These procedures allow for proper closure when necessary during speech but still allow for adequate nasal airflow.


Is VPI surgery always necessary?

No, generally with palate surgery speech is corrected. Only if air escape is present it is necessary to perform corrective VPI surgery

How do I know which procedure to have?

It will depend from the anatomic problem. Speech assessment and nasoendoscopy will determine which surgery is indicated.

Contact Us

Monday to Friday: 9am to 5pm

Saturday and Sunday – Closed

Midtown Office: 22 West 48th Street
(Suite 300) New York, NY 10036

Upper East Side Office: 900 Park Avenue
New York, New York, NY 10075

Midtown Office