Acquired Velopharyngeal Dysfunction: Survey, Literature Review, and Clinical Recommendations Purpose The aim of this study was to describe the clinical assessment recommendations for acquired velopharyngeal dysfunction (AVPD) and, through a literature review and online survey, summarize current practice patterns for evaluation and treatment pathway determination for this target population. Method An online survey to query current assessment ... Review Article
Newly Published
Review Article  |   September 07, 2018
Acquired Velopharyngeal Dysfunction: Survey, Literature Review, and Clinical Recommendations
 
Author Affiliations & Notes
  • Kelsey B. Guyton
    Department of Communication Disorders, Auburn University, AL
  • Mary J. Sandage
    Department of Communication Disorders, Auburn University, AL
  • Dallin Bailey
    Department of Communication Disorders, Auburn University, AL
  • Nancy Haak
    Department of Communication Disorders, Auburn University, AL
  • Lawrence Molt
    Department of Communication Disorders, Auburn University, AL
  • Allison Plumb
    Department of Communication Disorders, Auburn University, AL
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Mary Sandage: sandamj@auburn.edu
  • Editor-in-Chief: Julie Barkmeier-Kraemer
    Editor-in-Chief: Julie Barkmeier-Kraemer×
  • Editor: Nancy Solomon
    Editor: Nancy Solomon×
Article Information
Speech, Voice & Prosodic Disorders / Special Populations / Genetic & Congenital Disorders / Newly Published / Review Article
Review Article   |   September 07, 2018
Acquired Velopharyngeal Dysfunction: Survey, Literature Review, and Clinical Recommendations
American Journal of Speech-Language Pathology, Newly Published. doi:10.1044/2018_AJSLP-17-0222
History: Received December 19, 2017 , Revised April 18, 2018 , Accepted May 10, 2018
 
American Journal of Speech-Language Pathology, Newly Published. doi:10.1044/2018_AJSLP-17-0222
History: Received December 19, 2017; Revised April 18, 2018; Accepted May 10, 2018

Purpose The aim of this study was to describe the clinical assessment recommendations for acquired velopharyngeal dysfunction (AVPD) and, through a literature review and online survey, summarize current practice patterns for evaluation and treatment pathway determination for this target population.

Method An online survey to query current assessment procedures and treatment pathway recommendations for AVPD was developed. Following survey results, a literature review was completed to determine evidence-based recommendations for assessment procedures and intervention recommendations based on assessment findings. Literature search terms included the following: acquired velopharyngeal dysfunction, hypernasality, non–cleft velopharyngeal dysfunction, velopharyngeal dysfunction, velopharyngeal dysfunction AND iatrogenic, velopharyngeal dysfunction AND neurogenic, velopharyngeal dysfunction AND assessment OR evaluation, velopharyngeal dysfunction AND treatment OR intervention, velopharyngeal dysfunction AND practice patterns OR clinical guidelines, velopharyngeal insufficiency. Inclusion criteria were limited to practice patterns/recommendations for assessment and/or treatment recommendations for AVPD, English language articles published between 2000 and 2017, and peer-reviewed journals. Studies regarding solely congenital or cleft palate velopharyngeal dysfunction and intervention outcome studies were excluded. Forty articles met inclusionary criteria.

Results The online survey results indicated lack of consensus for AVPD assessment and treatment recommendation protocols, with 93% of respondents indicating the need for a clinical guide for developing treatment recommendations. The majority of recommendations were filtered into an algorithm for clinical decision making.

Conclusions Clinical uncertainty among speech-language pathologists surveyed and the paucity of published clinical guidelines for assessing individuals with AVPD indicate the need for additional clinical research for this disorder, one that is heterogeneous and distinct from those with congenital velopharyngeal dysfunction. The proposed evidence-based clinical worksheet may assist in determining management for patients with AVPD and may serve as a starting place for validation of a clinical guideline.

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