While cleft is the most common cause of VPI, other significant etiologies exist. These other causes are outlined in the chart below: VPI flow chart compiled from the following sources: Johns, Rohrich & Awada, 2003 and Peterson-Falzone, Karnell, Hardin-Jones,& Trost-Cardamone, 2005
Velopharyngeal inadequacy
Velopharyngeal insufficiency
Congenital cartilaginous rest of the neck
Patulous Eustachian tube
Nasal septum deviation
Salivary gland hypoplasia
Persistent thyroglossal duct
Esophageal motility disorder