Ally had her nasal scope done today, it started off alright with some simple routine procedures. Then we had to spray a numbing agent into her nose and I could see that she was thinking of the barium insertion. She hesitated but continued to be brave. On the first try she yanked the scope out, we explained to her that the more co-operative she was, the faster it would all be over. Second time around she was much better but she had difficulty swallowing her saliva so the images were rather blurry. I am really proud of her, I don’t think I would tolerate having a scope down my nose.
Even with no medical background, I could clearly see from the tv that her soft palate and pharynx didn’t fully close as she spoke. If you look at the picture below, when we speak our soft palate actually bends downward and meets the pharynx forming a seal.
In Ally’s case, there was a hole at the side when she speaks, which explains why she sounds like she’s grunting at times. Ally has been in regular speech therapy since she was 6 months old but no amount of therapy is going to help her with this as it’s now a structural issue. Before we ran these tests, we thought her grunting and snorting were just bad speech habits that she had picked up. Now we know she has Velopharyngeal insufficiency or VPI for short. The question is, do we put her through another surgery to close up the hole?
I am inclined to put her through it and continue with speech therapy but we won’t make any decisions till we meet with her surgeon in May. Honestly if you met Ally you would have never guessed that she has speech issues. Not only does she sound ” normal” she has a wide vocabulary and speaks articulately. Occasionally you might be able to pick up her grunting or snorting if you are observant enough. But due to that hole, she will always have trouble making high pressure sounds like ” s, z, sh….etc”
Important decisions have to be made, but we’re going to wait and consult her plastic surgeon before making our decision.