What is velopharyngeal insufficiency (VPI) primarily characterized by?

Velopharyngeal insufficiency (VPI) is primarily characterized by hypernasality during speech. This condition occurs when there is an incomplete closure of the velopharyngeal sphincter which separates the oral and nasal cavities. As a result, when a person speaks, the air can escape through the nose instead of solely through the mouth, leading to the characteristic nasal resonance or hypernasality.

Hypernasality is particularly evident with certain phonemes, especially high-pressure consonants, where proper closure of the velopharynx is necessary to maintain the appropriate sound quality. This is a key indicator of VPI, making it the most relevant symptom associated with the condition.

While other symptoms can appear in different conditions affecting the oral and maxillofacial region, they do not specifically relate to the characteristic effects of VPI on speech production, which is why hypernasality is recognized as the hallmark feature.