Children and adults who have velopharyngeal insufficiency (VPI) and nasal-sounding speech (hypernasality) may need pharyngoplasty. Pharyngoplasty is an operation to change the shape and function of your soft palate and the area around it (your pharynx).
Pharyngoplasty is a surgical procedure to change the shape and function of tissue in the soft palate (velum) in the roof of your mouth and the back of your throat (pharynx). When done for speech, the procedure decreases the amount of air flowing out your nose when you talk. Your healthcare provider might suggest pharyngoplasty if you have intensely nasal-sounding speech (hypernasality) that can be difficult for people to understand. Children and adults with this problem, called velopharyngeal insufficiency (VPI), may benefit from pharyngoplasty.
In addition, a different type of pharyngoplasty can be done to address sleep apnea in adults.
The surgery most commonly helps children born with a cleft palate (an opening in the roof of their mouth). This birth defect affects approximately 1 in 1,700 babies and is the leading cause of VPI. But adults can also have VPI. An estimated 1 in 3 children who have surgery to correct a cleft palate develop VPI and need pharyngoplasty.
Other causes of VPI in children and adults that may require pharyngoplasty include:
Healthcare providers also perform pharyngoplasty to treat adults who have sleep apnea that doesn’t improve with other therapies.
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The different types of pharyngoplasty include:
You should follow your healthcare provider’s instructions to prepare yourself or your child for pharyngoplasty. These instructions may include stopping certain medications, vitamins or herbal supplements.
All pharyngoplasty surgeries take place under general anesthesia, which means you or your child sleep through the procedure. Depending on the procedure, surgery may take up to two hours.
Pharyngoplasty steps vary depending on the type of procedure.
Most people stay in the hospital for one to three nights after pharyngoplasty. You or your child may experience:
These side effects of pharyngoplasty often resolve on their own in a few days. In rare instances (about 1 in 20), you may need a tube in your nose (nasopharyngeal airway) to help you breathe until the swelling goes down.
Benefits of pharyngoplasty include:
VPI can sometimes persist after a pharyngoplasty. Some people who get surgery to treat VPI develop loud snoring and sleep apnea. Snoring often improves over time. Your healthcare provider may recommend a sleep study (polysomnography) six months after surgery to check for signs of sleep apnea.
If VPI persists or sleep apnea occurs, your healthcare provider may perform a minor outpatient procedure. To treat VPI, they make the openings (ports) in your throat tissue smaller. They enlarge the ports to treat sleep apnea.
The recovery time after pharyngoplasty varies. You or your child should plan to miss a week of school or work to recover.
You should follow your healthcare provider’s recovery instructions, which may include:
Success rates for pharyngoplasty vary depending on the type:
You should call your healthcare provider if you or your child experiences signs of:
A note from Cleveland Clinic
Having nasal-sounding speech from velopharyngeal insufficiency (VPI) can make you self-conscious. The condition can make it difficult for others to understand what you’re saying. Pharyngoplasty treats VPI by repositioning tissue in your throat and mouth. After surgery, you or your child will have clearer speech. Pharyngoplasty can also open your airways and improve breathing if you have sleep apnea. Your healthcare provider can explain the risks and benefits of pharyngoplasty.
Last reviewed by a Cleveland Clinic medical professional on 06/06/2023.
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