Speech Outcome After Partial Adenoidectomy in Patients With Risk of Hypernasality

Sohag University

Status: Unknown

Conditions: Hypernasality

Treatments: Procedure: Partial Adenoidectomy

Study type: Interventional

Funder types: Other

Identifiers

NCT05273853

DAHAllah

Details and patient eligibility

About

Adenoid hypertrophy is a common cause of airway obstruction in children; it may lead to mouth breathing, nasal discharge, snoring, sleep apnea, and hyponasal speech.

Full description

Adenoid hypertrophy is a common cause of airway obstruction in children; it may lead to mouth breathing, nasal discharge, snoring, sleep apnea, and hyponasal speech. It also contributes to the pathogenesis of rhinosinusitis and recurrent otitis media. However, the adenoid lies in the posterior nasopharyngeal wall and may act as a pad against the palate facilitating velopharyngeal closure, especially in patients with palatal abnormalities; Its presence can compensate for a short or poorly mobile palate. Following adenoidectomy, compensation is eliminated and velopharyngeal insufficiency (VPI) may result. Therefore, patients with palatal abnormalities (such as poor palatal mobility, short palate, occult submucosal cleft palate, scarred palate after previous tonsillectomy, and repaired cleft palate) are at high risk to develop hypernasality after complete adenoidectomy, and in such situations conservative or partial adenoidectomy is performed

Enrollment: 30 estimated patients

Sex: All

Ages: 1 to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patient with symptoms of adenoid hypertrophy.

2. High risk to VPI:

   1. Short palate.
   2. Scarred palate after previous tonsillectomy.
   3. Occult submucous cleft.
   4. Deep pharynx.
   5. Repaired cleft palate.

Exclusion criteria

• Any neurological deficit, muscular disorder or structural defects of the palate (as cleft palate).

Trial design

Primary purpose: Prevention

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

30 participants in 1 patient group

Patients with high risk of hypernasality

Other group

Description:

In 1958, Gibb indicated an incidence of hypernasality (escape of air from nose as in patients with cleft palate) postadenoidectomy in approximately 1of 2000 cases. Closure pattern of velopharyngeal valve in children is veloadenoidal rather than velopharyngeal closure. Adenoid tissue is vital to velopharyngeal closure in children and its removal necessitates a change in the closure pattern of velopharyngeal valving. These changes are easily overcome if there is no anatomic abnormality

Treatment:

Procedure: Partial Adenoidectomy