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Altered speech following adenoidectomy: a 20 year experience.

K J Stewart1, T Ahmad, R E Razzell

  • 1Department of Plastic Surgery, Royal Hospital for Sick Children, Edinburgh, UK.

British Journal of Plastic Surgery
|December 14, 2002
PubMed
Summary
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Altered speech after adenoidectomy is rare, occurring in 1 in 1200 cases. Multidisciplinary assessment and treatment, including speech therapy or surgery, significantly improve outcomes for most patients.

Area of Science:

  • Otolaryngology
  • Speech Pathology
  • Pediatric Surgery

Background:

  • Adenoidectomy, a common procedure, can rarely lead to velopharyngeal insufficiency and altered speech.
  • Persistent speech changes post-adenoidectomy necessitate specialized investigation and management.

Purpose of the Study:

  • To determine the incidence, clinical features, and causes of persistent altered speech following adenoidectomy.
  • To evaluate the effectiveness of a selective treatment strategy for these patients.

Main Methods:

  • Prospective data collection over 20 years from 42 patients referred to a multidisciplinary cleft team.
  • Investigation included videofluoroscopy and nasopharyngoscopy.
  • Treatment decisions based on multidisciplinary assessment and diagnostic findings.

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Main Results:

  • Incidence of persistent altered speech was 1 in 1200 adenoidectomies.
  • Diagnoses included velopharyngeal disproportion, cleft palate variations, and developmental causes.
  • Speech therapy benefited 13 patients; 23 required surgery (pharyngeal flap, sphincteric pharyngoplasty, intravelar veloplasty).
  • Treatment led to significant speech improvement in 35 of 36 assessed patients, with 16 achieving normal speech.

Conclusions:

  • Persistent altered speech is a rare but significant complication of adenoidectomy.
  • Multidisciplinary assessment and multi-modality investigation are crucial for diagnosis and management.
  • A selective treatment approach yields excellent outcomes in the majority of affected patients.