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Velopharyngeal insufficiency in patients without a cleft palate: important considerations for the ENT surgeon

Published online by Cambridge University Press:  06 March 2020

E Mushi ,
N Mahdi ,
N Upile ,
C Hevican ,
S McKernon ,
S van Eeden  and
S De
E Mushi*
Affiliation:
Otolaryngology and Head and Neck Surgery Department, University Hospital Aintree, Liverpool, UK
N Mahdi
Affiliation:
Royal Manchester Children's Hospital, UK
N Upile
Affiliation:
Otolaryngology Head and Neck Surgery Department, Queen Victoria Hospital NHS Foundation Trust, West Sussex, UK
C Hevican
Affiliation:
Department of Plastics and Reconstructive Surgery, University College Hospital Galway, Ireland
S McKernon
Affiliation:
University of Liverpool, UK
S van Eeden
Affiliation:
Department of Cleft Lip and Palate and Maxillofacial, Alder Hey Children's Hospital, Liverpool, UK
S De
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Alder Hey Children's Hospital, Liverpool, UK
*
Author for correspondence: Ms Eriola Mushi, Otolaryngology and Head and Neck Surgery Department, University Hospital Aintree, Lower Lane, LiverpoolL9 7AL, UK E-mail: eriola.mushi@liverpoolft.nhs.uk
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Abstract

Background

Velopharyngeal insufficiency is the inability to close the velopharyngeal port during speech and swallowing, leading to hypernasal speech and food regurgitation.

Objective

This study aimed to explore the aetiological factors contributing to the development of velopharyngeal insufficiency in a non-cleft paediatric population, especially following adenoidectomy.

Methods

A retrospective case review was conducted of all children without a known cleft palate, born between 2000 and 2013, who were referred to a tertiary cleft centre with possible velopharyngeal insufficiency.

Results

The data for 139 children diagnosed with velopharyngeal insufficiency following referral to the cleft centre were analysed. Thirteen patients developed the condition following adenoidectomy; only 3 of these 13 had a contributing aetiological factor.

Conclusion

Velopharyngeal insufficiency is a rare but significant complication of adenoidectomy. The majority of patients who developed velopharyngeal insufficiency following adenoidectomy did not have an identifiable predisposing factor. This has important implications for the consent process and when planning adenoidectomy.

Keywords

Velopharyngeal InsufficiencyAdenoidectomySubmucous Cleft PalateInformed Consent
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 3 , March 2020 , pp. 252 - 255
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

Ms E Mushi takes responsibility for the integrity of the content of the paper

This work was presented: as a poster at the 15th British Academic Conference in Otolaryngology, 8–10 July 2015, Liverpool, UK, orally at the British Association of Paediatric Otolaryngology annual meeting, 18 September 2015, Dublin, Ireland, and orally at the European Society of Paediatric Otolaryngologists Congress, 18–21 June 2016, Lisbon, Portugal.

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