Speech Outcome After Partial Adenoidectomy in Patients With Risk of Hypernasality

Study Overview
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Brief Summary
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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.

Detailed Description
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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

Official Title
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Speech Outcome After Partial Adenoidectomy in Patients With Risk of Hypernasality

Conditions
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Hypernasality

Intervention / Treatment
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* Procedure: Partial Adenoidectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient with symptoms of adenoid hypertrophy. High risk to VPI: Short palate. Scarred palate after previous tonsillectomy. Occult submucous cleft. Deep pharynx. Repaired cleft palate. Exclusion Criteria: Any neurological deficit, muscular disorder or structural defects of the palate (as cleft palate).

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Patients with high risk of hypernasality<br>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 | Procedure: Partial Adenoidectomy<br>* Partial removal of adenoid<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Speech Outcome | Change of a degree of Nasal Tone during speech | 1 month after operation | 
| Speech Outcome | Change of a degree of Nasal Tone during speech | 3 months after operation |