The posterior velar apex defined and its importance in the assessment of velopharyngeal dysfunction. An update of the surface anatomy of the hard and soft palate.

Soft palate (velar) elevation closes the posterior nasopharynx and prevents the escape of nasal passage air in speech or food during swallowing. However, when the velum is not symmetrical, incomplete closure may occur on one side, which is important in the assessment of speech hypernasality, principally after previously repaired cleft palate. This may present as a short anteroposterior length on one side of the uvula that leaves a gap in closure behind the velum. In the absence of an anatomical term, we have defined the posterior velar apex as the most anterior point on the free edge of the posterior border of the soft palate. It is a paired point, with one on each side of the uvula, and is important in the assessment of unilateral anatomical causes of velopharyngeal dysfunction. Synonymous terms would be "left/right posterior velar apex," "posterior hemivelar apex," or even simply, "left/right velar apex".