Question:  A 60 year old male is referred to you for speech abnormalities. He reports undergoing radiation for nasopharyngeal carcinoma 20 years previously. While interviewing him you note significant hypernasality. Speech endoscopy reveals velopharyngeal insufficiency with a sagittal closure pattern. Apart from injection pharyngoplasty, what surgical intervention is indicated? [Answer will be posted with next week's new question]

Answer to last week's question, "A Spectrum of Possibilities" (January 16, 2017)

 

Auditory neuropathy spectrum disorder.