Velopharyngeal Stenosis After Adenotonsillectomy in a Child: A Case Report

Velopharyngeal stenosis is a rare condition characterized by partial or complete obliteration of the velopharyngeal port and may present with snoring, obstructive sleep symptoms, and speech abnormalities, typically following oropharyngeal surgery. We report the case of a 6-year-old boy who developed persistent diurnal and nocturnal snoring accompanied by recurrent coughing 4 months after adenotonsillectomy. Endoscopic evaluation revealed significant stenosis of the velopharyngeal port. The patient initially underwent surgical release and dilation of the stenotic segment, resulting in temporary symptom improvement; however, symptoms recurred 2 months later due to restenosis. A second surgical intervention was performed with placement of a stent across the stenotic segment to maintain patency during healing. Following stent placement, the patient experienced complete resolution of symptoms, and no further recurrence was observed during follow-up. This case highlights velopharyngeal stenosis as a rare but clinically significant complication of adenotonsillectomy in children and underscores the challenges associated with its management because of the risk of recurrence. It also demonstrates the potential role of stenting as an adjunctive measure to prevent restenosis and achieve sustained symptom resolution. Awareness of this complication and meticulous surgical technique during oropharyngeal procedures may help reduce its occurrence and improve patient outcomes.