[Rhinolalia aperta after the use of a postnasal pack as a medico-legal problem (author's transl)]

A 23 year old patient needed a postnasal pack after tonsillectomy and adenoidectomy for control of severe postoperative bleeding. After removal of the pack on the sixth day, the patient had rhinolalia aperta. The patient could still swallow normally and there was no nasal regurgitation when swallowing solids or fluids. The patient sued for damage when 6 months of speech therapy failed to give any improvement of the nasal speech. The patient argued that the surgeon was negligent in leaving the postnasal pack in position for too long, and resulted in a paresis of the soft palate. However, a careful review of the record indicates that no real paresis of the musculature of the soft palate had occurred since the nasopharynx could be closed by the soft palate during deglutition. The patient's complaints were more likely psychologically induced, although there is no known case in the otolaryngologic literature on this syndrome in which phoniatric function did not recover spontaneously or after speech therapy.