Assessment of velopharyngeal valve mechanism before and after adenotonsillectomy with different techniques | ||||
| Egyptian Journal of Neck Surgery and Otorhinolaryngology | ||||
| Articles in Press, Accepted Manuscript, Available Online from 29 July 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejnso.2025.398614.1126 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Mohammed azzam abdel-razek1; Hanan Abdelrashed Mohamed2; Fatma mohamed Abdullah  1; Mahmoud Ali Ragaee AbdElHakeem 1
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| 1Otorhinolaryngology Department, Faculty of Medicine, Assiut university, Egypt | ||||
| 2Phoniatric Unit, ENT Department, Faculty of Medicine, Assiut University, Assiut, Egypt. | ||||
| Abstract | ||||
| Background: Velopharyngeal insufficiency (VPI) can occur after adenoidectomy, tonsillectomy or adenotonsillectomy and may be affected by the type of technique hot or cold, preservation of anatomical land mark and postoperative pain. Objective: The study aimed to detect the effect of adenotonsillectomy with different techniques on the velopharyngeal valve mechanism to predict and prevent post-operative velopharyngeal insufficiency(VPI). Methodology: 220 children aged from (4-12) years old that were underwent (adenoidectomy, tonsillectomy or adeno-tonsillectomy) they were done by (cold dissection, electrocautery, cold dissection with electrocautery hemostasis and coblation). All children were evaluated preoperatively and postoperatively by using the protocol of evaluation of speech in Phoniatric Unit in Assiut university Hospital including an auditory perceptual assessment (APA) of speech, visual assessment of vocal tract and assessment of velopharyngeal valve by flexible fiberoptic laryngoscope. Results: The majority (90.5%) exhibited no open or closed nasality post-operatively, (8.1%) exhibited mild degree of open nasality that improved after 1 month. Restricted palatal mobility occurs in 5.9% of cases post-operatively after one week and in 1.3% of cases after one month. Transient velopharyngeal gap occurs in 4.1% of cases after one week and in 1.3%in cases after one month and resolved completely after 3 month. The bipolar and Curette techniques had a significant association with postoperative complication. Conclusion: Bipolar or coagulation electrocautery group showed significantly higher incidence of hypernasality that appear in the first week following surgery than other techniques that is most likely related to the postoperative pain and longer post-operative healing time | ||||
| Keywords | ||||
| Adenontonsillectomy; VPI; palatal mobility; surgical techniques | ||||
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