Treatment of the Velum

  • William S. TierneyEmail author
  • Paul C. Bryson


The soft palate or velum is a soft tissue structure involved in speech and swallowing. Many anatomic and neuromuscular diseases can modify its function and even small derangements can result in remarkable pathology. Recognizing these disorders requires special attention to velar signs and symptoms during the history and physical examination. Multiple testing modalities are commonly instituted in the office to aid in recognition of these pathologies, most commonly transnasal flexible endoscopy to recognize anatomic and functional changes in velopharyngeal competence and motion. Velar pathology can be grossly categorized as either hypofunctional velopharyngeal insufficiency or hyperfunctional spastic neuromuscular disorders. The former are commonly treated with surgical and procedural interventions to augment velopharyngeal closure while the latter are most often treated with botulinum toxin injection to modulate hyperfunctional muscular contractions. This chapter outlines the basics of diagnosis, testing, and treatment of velar pathology.


Neuromuscular Velum Soft palate Velopharyngeal Velopharyngeal insufficiency Palatal tremor Palatal spasm Spasmodic dysphonia Laryngology Neurolaryngology Botulinum toxin Palatoplasty Pharyngoplasty 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Head and Neck Institute, Cleveland ClinicClevelandUSA

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