Semin Speech Lang 2011; 32(2): 083-092
DOI: 10.1055/s-0031-1277712
© Thieme Medical Publishers

Anatomy and Physiology of the Velopharyngeal Mechanism

Jamie L. Perry1
  • 1Department of Communication Sciences and Disorders, Illinois State University, Normal, Illinois
Further Information

Publication History

Publication Date:
26 September 2011 (online)


Understanding the normal anatomy and physiology of the velopharyngeal mechanism is the first step in providing appropriate diagnosis and treatment for children born with cleft lip and palate. The velopharyngeal mechanism consists of a muscular valve that extends from the posterior surface of the hard palate (roof of mouth) to the posterior pharyngeal wall and includes the velum (soft palate), lateral pharyngeal walls (sides of the throat), and the posterior pharyngeal wall (back wall of the throat). The function of the velopharyngeal mechanism is to create a tight seal between the velum and pharyngeal walls to separate the oral and nasal cavities for various purposes, including speech. Velopharyngeal closure is accomplished through the contraction of several velopharyngeal muscles including the levator veli palatini, musculus uvulae, superior pharyngeal constrictor, palatopharyngeus, palatoglossus, and salpingopharyngeus. The tensor veli palatini is thought to be responsible for eustachian tube function.


  • 1 Moon J B, Kuehn D P. Anatomy and physiology of normal and disordered velopharyngeal function for speech. In: Bzoch K R, ed. Communicative Disorders Related to Cleft Lip and Palate, 5th ed. Austin, TX: Pro-Ed; 2004: 67-98
  • 2 Kummer A W. Anatomy and physiology: the orofacial structures and velopharyngeal valve. In: Kummer A W, ed. Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance, 2nd ed. Clifton Park, NY: Delmar Cengage; 2008: 3-30
  • 3 Ettema S L, Kuehn D P. A quantitative histologic study of the normal human adult soft palate.  J Speech Hear Res. 1994;  37 (2) 303-313
  • 4 Kuehn D P, Kahane J C. Histologic study of the normal human adult soft palate.  Cleft Palate J. 1990;  27 (1) 26-34 discussion 35
  • 5 Kuehn D P, Moon J B. Histologic study of intravelar structures in normal human adult specimens.  Cleft Palate Craniofac J. 2005;  42 (5) 481-489
  • 6 Finkelstein Y, Lerner M A, Ophir D, Nachmani A, Hauben D J, Zohar Y. Nasopharyngeal profile and velopharyngeal valve mechanism.  Plast Reconstr Surg. 1993;  92 (4) 603-614
  • 7 Witzel M A, Posnick J C. Patterns and location of velopharyngeal valving problems: atypical findings on video nasopharyngoscopy.  Cleft Palate J. 1989;  26 (1) 63-67
  • 8 Huang M H, Lee S T, Rajendran K. Anatomic basis of cleft palate and velopharyngeal surgery: implications from a fresh cadaveric study.  Plast Reconstr Surg. 1998;  101 (3) 613-627 discussion 628-629
  • 9 Boorman J G, Sommerlad B C. Levator palati and palatal dimples: their anatomy, relationship and clinical significance.  Br J Plast Surg. 1985;  38 (3) 326-332
  • 10 Azzam N A, Kuehn D P. The morphology of musculus uvulae.  Cleft Palate J. 1977;  14 (1) 78-87
  • 11 Kuehn D P, Folkins J W, Cutting C B. Relationships between muscle activity and velar position.  Cleft Palate J. 1982;  19 (1) 25-35
  • 12 Abe M, Murakami G, Noguchi M, Kitamura S, Shimada K, Kohama G I. Variations in the tensor veli palatini muscle with special reference to its origin and insertion.  Cleft Palate Craniofac J. 2004;  41 (5) 474-484
  • 13 Barsoumian R, Kuehn D P, Moon J B, Canady J W. An anatomic study of the tensor veli palatini and dilatator tubae muscles in relation to eustachian tube and velar function.  Cleft Palate Craniofac J. 1998;  35 (2) 101-110
  • 14 Leider J, Hamlet S, Schwan S. The effect of swallowing bolus and head position on eustachian tube function via sonotubometry.  Otolaryngol Head Neck Surg. 1993;  109 (1) 66-70
  • 15 Kuehn D P. Velopharyngeal anatomy and physiology.  Ear Nose Throat J. 1979;  58 (7) 316-321
  • 16 Cassell M D, Moon J B, Elkadi H. Anatomy and Physiology of the Velopharynx. Multidisciplinary Management of Cleft Lip and Palate. Philadelphia, PA: Saunders; 1990
  • 17 Moon J B, Smith A E, Folkins J W, Lemke J H, Gartlan M. Coordination of velopharyngeal muscle activity during positioning of the soft palate.  Cleft Palate Craniofac J. 1994;  31 (1) 45-55
  • 18 Seaver III E J, Kuehn D P. A cineradiographic and electromyographic investigation of velar positioning in non-nasal speech.  Cleft Palate J. 1980;  17 (3) 216-226
  • 19 Kuehn D P, Folkins J W, Linville R N. An electromyographic study of the musculus uvulae.  Cleft Palate J. 1988;  25 (4) 348-355
  • 20 Fritzell B. The velopharyngeal muscles in speech. An electromyographic and cinéradiographic study.  Acta Otolaryngol. 1969;  (Suppl 250) 1 + 
  • 21 Trigos I, Ysunza A, Vargas D, Vazquez M C. The San Venero Roselli pharyngoplasty: an electromyographic study of the palatopharyngeus muscle.  Cleft Palate J. 1988;  25 (4) 385-388
  • 22 Kuehn D P, Azzam N A. Anatomical characteristics of palatoglossus and the anterior faucial pillar.  Cleft Palate J. 1978;  15 (4) 349-359
  • 23 Huang M H, Lee S T, Rajendran K. A fresh cadaveric study of the paratubal muscles: implications for eustachian tube function in cleft palate.  Plast Reconstr Surg. 1997;  100 (4) 833-842
  • 24 Dickson D R, Dickson W M. Velopharyngeal anatomy.  J Speech Hear Res. 1972;  15 (2) 372-381
  • 25 Shimokawa T, Yi S, Tanaka S. Nerve supply to the soft palate muscles with special reference to the distribution of the lesser palatine nerve.  Cleft Palate Craniofac J. 2005;  42 (5) 495-500
  • 26 Kennedy J G, Kuehn D P. Neuroanatomy of speech. In: Kuehn D P, Lemme M L, Baumgartner J M, eds. Neural Bases of Speech, Hearing, and Language. Boston, MA: Little Brown; 1989
  • 27 Nishio J, Matsuya T, Machida J, Miyazaki T. The motor nerve supply of the velopharyngeal muscles.  Cleft Palate J. 1976;  13 20-30
  • 28 Kuehn D P, Templeton P J, Maynard J A. Muscle spindles in the velopharyngeal musculature of humans.  J Speech Hear Res. 1990;  33 (3) 488-493
  • 29 Liss J M. Muscle spindles in the human levator veli palatini and palatoglossus muscles.  J Speech Hear Res. 1990;  33 (4) 736-746
  • 30 Peterson-Falzone S, Hardin-Jones M, Karnell M. Cleft Palate Speech. St. Louis, MI: Mosby; 2001

Jamie L PerryPh.D. 

Department of Communication Sciences and Disorders, Illinois State University

208 Rachel Cooper, Normal, IL 61790