Related Experiment Videos
Velopharyngeal insufficiency following palatine tonsillectomy
M L Haapanen1, J Ignatius, H Rihkanen
1Department of Plastic Surgery, Helsinki University Central Hospital, Finland.
Summary
Tonsillectomy can rarely cause severe velopharyngeal insufficiency (VPI) due to nerve damage. Postoperative examination is crucial for identifying VPI causes and planning treatment after this common surgery.
Area of Science:
- Otolaryngology
- Neurology
Background:
- Adenotonsillectomy is a common procedure, but severe complications like velopharyngeal insufficiency (VPI) can occur.
- Recurrent peritonsillar abscesses are a specific indication for palatine tonsillectomy.
Observation:
- Two cases of severe VPI following palatine tonsillectomy for recurrent peritonsillar abscesses are presented.
- Clinical examination, nasalance measurements, videonasopharyngoscopy, and videofluoroscopy were utilized.
Findings:
- VPI in both patients was linked to nerve damage, specifically branches of the vagus and glossopharyngeal nerves, and possibly the hypoglossal nerve.
- Preoperative velopharyngeal anatomy varied significantly between the two patients.
Implications:
- Postoperative endoscopic and videofluoroscopic evaluations are vital for diagnosing VPI after tonsillectomy.
- Identifying specific nerve involvement and anatomical factors aids in tailoring VPI treatment strategies.