Association between post-adenoidectomy hypernasality and velopharyngeal valve closure patterns

Hypernasality is a speech disorder that is frequently associated with various pathological conditions. However, its precise prevalence following adenoidectomy remains unclear. This study aimed to investigate the possible relation between velopharyngeal valve (VPV) closure patterns and the development of hypernasality following adenoidectomy.

A prospective observational study was conducted on 100 children, aged 6-12 years, with adenoid hypertrophy who underwent total adenoidectomy after nasoendoscopic evaluation of velopharyngeal valve function. All participants were evaluated for postoperative hypernasality at 2 weeks and monthly up to 3 months.

Preoperatively, all patients had good intelligibility of speech, 85% of cases had normal resonance, while 15% had a mild degree of hyponasality. Nasofibroscopic examination showed incomplete adenoid closure, adequate palatal length and mobility, and complete velopharyngeal valve closure in all subjects. Regarding velopharyngeal valve closure pattern, 65% of patients exhibited a coronal pattern and 35% a circular pattern. Postoperatively, only 5% of patients developed mild transient hypernasality at the two-week follow-up, while 95% maintained normal resonance. By the one-month assessment, all patients had achieved normal resonance.

There was no significant association between VPV closure patterns and the development of postoperative hypernasality. Meticulous preoperative assessment of VPV function can effectively minimize the risk of post-adenoidectomy hypernasality.