|Anna Domeracka-Kołodziej, Barbara Maniecka-Aleksandrowicz, Beata Zielnik-Jurkiewicz, Renata Zawadzka, Magdalena Rakowska, Alicja Różak-Komorowska, Alicja Szeptycka-Adamus|
Introduction. Velopharyngeal insufficiency is one of the complications of adenoidectomy or adenotonsillotomy. Its most common etiology is submucous cleft palate or some other forms of palatal dysplasia.
Aim. To assess the prevalence of palatal dysplasia in children diagnosed with pharyngeal lymphatic hypertrophy and referred for adenoidectomy or adenotonsillotomy, and to compare pre- and post-surgery nasality and nasalance.
Material and methods. The participants of the study included 104 children that were referred for adenoidectomy or adenotonsillotomy by a paediatric laryngologists and, because of a palatal defect, sought a phoniatric consultation. The children underwent objective nasality assessment, including the calculation of the value of factor K. The examinations were repeated after the surgery and supplemented by a questionnaire interview with the parents of the children.
Results. Preoperative examination showed short velum in ca. 83%, bifid uvula in ca. 26%, and submucous cleft palate in ca. 17% of the children. In perceptual speech assessment, 11% of the children had hyponasality, while none of them had hypernasality. The value of the factor K was small, within 15% in ca. 68% of the children, while in 32% it was elevated.
During the postoperative period, temporary (max. 10-day) hypernasality was noted by the parents in ca. 19% children. However, phoniatric follow-up did not reveal hypernasality in any of the children. The value of factor K in the majority of the children was within the same range, while in 6 of 43 children (ca. 14%) an evident change in the value of that factor was observed, indicating a higher nasal resonance.
Conclusions. Nasalance assessment is a useful diagnostic method of predicting a possible occurrence of hypernasality in children after adenoidectomy or adenotonsillotomy, which may be particularly useful in children with co-existent palatal dysplasia.
keywords: adenoidektomia, adenotonsilotomia, dysplazja podniebienia, niewydolność podniebienno-gardłowa, nosowanie, współczynnik nosowości, adenoidectomy, adenotonsillotomy, congenital palate defect, velopharyngeal insufficiency, nasality, nasalance measurements
pages: from 135 to 141
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