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Management of velopharyngeal insufficiency in the presence of enlarged tonsils: comparing a one-stage versus two-stage treatment result.

Abstract
Alterations in velopharyngeal function after removal of enlarged tonsils were noted. However, the changes varied from previous reports. The purposes of this study were to examine the effect of tonsillectomy on velopharyngeal function and to look for proper management of velopharyngeal insufficiency in the presence of enlarged tonsils. Thirty patients who received tonsillectomy at one craniofacial centre were reviewed. The influence of tonsillectomy on velopharyngeal function was examined and correlations to nasopharyngoscopic or videofluoroscopic findings were made. The outcomes between simultaneous and staged tonsillectomy and velopharyngeal surgery were compared. Tonsillectomy was found to either improve or impair velopharyngeal function in a small proportion of patients; however, it did not alter the surgical management of velopharyngeal insufficiency. Nasopharyngoscopic or videofluoroscopic findings did not predict the influence of tonsillectomy on velopharyngeal function. Finally, simultaneous tonsillectomy and velopharyngeal surgery had an efficacy and complication rate comparable to that of the staged approach.
AuthorsTai-Lin Hu, Claudia Yun, Ruby Wang, Philip K T Chen, Lun-Jou Lo
JournalJournal of plastic, reconstructive & aesthetic surgery : JPRAS (J Plast Reconstr Aesthet Surg) Vol. 61 Issue 8 Pg. 883-8 (Aug 2008) ISSN: 1878-0539 [Electronic] Netherlands
PMID17588509 (Publication Type: Comparative Study, Journal Article)
Topics
  • Child
  • Child, Preschool
  • Cleft Palate (complications)
  • Female
  • Fluoroscopy
  • Humans
  • Hyperplasia (complications, surgery)
  • Male
  • Palate, Soft (physiopathology)
  • Palatine Tonsil (pathology)
  • Retrospective Studies
  • Tonsillectomy
  • Treatment Outcome
  • Velopharyngeal Insufficiency (complications, congenital, physiopathology, surgery)

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