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Velopharyngeal insufficiency following adenoidectomy
N C Saunders1, B E J Hartley, D Sell
1Department of Otolaryngology, Great Ormond Street Hospital, London, UK.
Clinical Otolaryngology and Allied Sciences
|November 10, 2004
Summary
Velopharyngeal insufficiency (VPI) after adenoidectomy is rare but can occur. Most children achieve normal speech with specialist care, including surgery and speech therapy.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Speech Pathology
Background:
- Velopharyngeal insufficiency (VPI) is a recognized, albeit rare, complication following adenoidectomy.
- This study reviews cases of VPI in children post-adenoidectomy.
Purpose of the Study:
- To analyze the causes, management, and outcomes of VPI in children after adenoidectomy.
- To identify previously unreported etiologies of post-adenoidectomy VPI.
Main Methods:
- Retrospective review of 20 children diagnosed with VPI post-adenoidectomy at a specialist hospital between 1993 and 2000.
- Assessment of etiology, treatment interventions (surgical and speech therapy), and speech outcomes.
Main Results:
- The most frequent cause was occult submucous cleft palate (5 cases).
- Two cases with behavioral disorders and normal palates presented with mild VPI, a novel finding.
- Surgical intervention was required for 9 children, with 3 needing revision procedures.
- Of 15 treated children with available follow-up, 13 achieved normal or near-normal speech.
Conclusions:
- Post-adenoidectomy VPI often has unforeseeable causes.
- Referral to a specialist cleft unit facilitates successful speech rehabilitation in most cases.
- A combined approach of surgery and speech therapy is effective for managing VPI post-adenoidectomy.