Journal article
Adenoidectomy and persistent velopharyngeal insufficiency: Considerations, risk factors, and treatment
International journal of pediatric otorhinolaryngology, Vol.149, pp.110846-110846
10/01/2021
DOI: 10.1016/j.ijporl.2021.110846
PMID: 34329831
Abstract
Importance: Persistent velopharyngeal insufficiency (VPI) is a rare but well-recognized complication of adenoidectomy. VPI can have a significant impact on the communication of a child. Objective: To describe the pathophysiology of post-adenoidectomy VPI, identify its associated risk factors, and illustrate the techniques used to treat the entity. Evidence review: A search of English or translated English articles concerning adenoidectomy, partial adenoidectomy, superior adenoidectomy; and velopharyngeal insufficiency, speech and voice from 1980 to 2021 was performed using Pubmed and Embase. Data from prospective and retrospective studies and their relevant references were pooled. Results: By objective measures, hypernasality is noted in many pediatric patients post-adenoidectomy, but this typically resolves in 3-6 months. Risk factors for the development of post-adenoidectomy VPI include low birth weight, family history of hypernasality, and history of speech problems or nasal regurgitation. The cleft palate, submucous cleft palate, poor palate mobility, and a deep pharynx may indicate susceptibility to VPI. Speech therapy is successful in up to 50% of patients, while surgical intervention may be tailored based on the diagnostic evaluation of the velopharynx with videofluoroscopy or nasoendoscopy. Conclusion: We present a comprehensive review of the literature on the pathophysiology, risk factors, and treatment of post-adenoidectomy VPI. We hope to bring awareness to the factors that can lead to a rare but potentially devastating complication in one of the most common procedures performed by Otolaryngologists.
Details
- Title: Subtitle
- Adenoidectomy and persistent velopharyngeal insufficiency: Considerations, risk factors, and treatment
- Creators
- Elton M. Lambert - Department of Otolaryngology-Head and Neck Surgery, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin Street D.640, Houston, TX, 77030, USAPeng You - Department of Otolaryngology-Head and Neck Surgery, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin Street D.640, Houston, TX, 77030, USADeborah S. Kacmarynski - University of Iowa Hospitals and ClinicsTara L. Rosenberg - Department of Otolaryngology-Head and Neck Surgery, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin Street D.640, Houston, TX, 77030, USA
- Resource Type
- Journal article
- Publication Details
- International journal of pediatric otorhinolaryngology, Vol.149, pp.110846-110846
- DOI
- 10.1016/j.ijporl.2021.110846
- PMID
- 34329831
- NLM abbreviation
- Int J Pediatr Otorhinolaryngol
- ISSN
- 0165-5876
- eISSN
- 1872-8464
- Publisher
- Elsevier
- Number of pages
- 7
- Language
- English
- Date published
- 10/01/2021
- Academic Unit
- Stead Family Department of Pediatrics; Craniofacial Anomalies Research Center; Otolaryngology
- Record Identifier
- 9984311439502771
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