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.

中文翻译：

---

腺样体切除术和持续性腭咽功能不全：注意事项、危险因素和治疗

重要性

持续性腭咽功能不全（VPI）是腺样体切除术的一种罕见但公认的并发症。VPI 可以对孩子的交流产生重大影响。

客观的

描述腺样体切除术后 VPI 的病理生理学，确定其相关风险因素，并说明用于治疗实体的技术。

证据审查

搜索有关腺样体切除术、部分腺样体切除术、上位腺样体切除术的英文或英文译文；1980 年至 2021 年的腭咽功能不全、言语和声音使用 Pubmed 和 Embase 进行。来自前瞻性和回顾性研究的数据及其相关参考资料被汇总。

结果

通过客观测量，许多儿科患者在腺样体切除术后会出现鼻音亢进，但这通常会在 3-6 个月内消退。发生腺样体切除术后 VPI 的危险因素包括低出生体重、过度鼻炎的家族史以及言语问题或鼻腔反流史。腭裂、黏膜下腭裂、腭活动性差和咽深部可能表明对 VPI 易感。言语治疗在高达 50% 的患者中是成功的，而手术干预可以根据使用视频透视或鼻内窥镜检查对腭咽部的诊断评估进行定制。

结论

我们对有关腺样体切除术后 VPI 的病理生理学、危险因素和治疗的文献进行了全面回顾。我们希望让人们意识到在耳鼻喉科医师执行的最常见手术之一中可能导致罕见但具有潜在破坏性并发症的因素。