2020 Volume 123 Issue 5 Pages 371-376
Velopharyngeal insufficiency is one of the common complications of adenoidectomy, but conservative treatments are sufficient for obtaining improvement in most cases. We encountered a patient who presented with severe hypernasality developing after adenoidectomy and required surgical treatment for improvement.
A five-year-old girl with bilateral otitis media with effusion and adenoid vegetation underwent adenoidectomy. After the surgery, she developed hypernasality with decreased speech clarity. Speech training was started 4 months after the operation and applied for 10 months, but the symptoms showed no improvement. Radiologic investigations revealed a very deep nasopharynx. Congenital velopharyngeal incompetence was considered as the cause of the velopharyngeal insufficiency, which had been asymptomatic prior to the adenoidectomy, probably as a result of the valve effect of the adenoids. The patient underwent surgery wherein the costal cartilage was transplanted into the posterior pharyngeal wall, which led to resolution of the hypernasality. Here, we discuss the possibility of preoperative detection and treatment methods for velopharyngeal insufficiency after adenoidectomy.
