Erin,

 

I spoke to a colleague who specializes in VPI.  She recommended focusing on head positioning, posture and a good lingual seal to help prevent nasal regurgitation. 

 

If the head is tipped anteriorly or posteriorly, there is a greater chance of the liquid sloshing against the posterior pharyngeal wall and into the nasopharynx.  Bringing more attention to the lingual seal with the palate will also increase control of the bolus and help propel the bolus down.

 

My colleague also mentioned that certain foods and liquids can increase nasal regurgitation.  She said that there isn't any research backing this, but it is mentioned in a few ENT books and she has also noticed a pattern.  Apparently chocolate is commonly mentioned by patients.  She also mentioned other acidic liquids (orange juice, coffee and wine).  It would be interesting if this is the case with your patients.  Are they chocolate milk or Ensure drinkers?

 

Hope this helps as an alternative to a palatal lift.

 

Jenna